About scurvy, all are true EXCEPT: September 2012
**Core Concept**
Scurvy is a disease caused by a deficiency of vitamin C (ascorbic acid) in the diet. It affects collagen synthesis, leading to various clinical manifestations. In scurvy, the body's ability to synthesize collagen is impaired due to the lack of vitamin C, which is essential for hydroxylation of proline and lysine residues in collagen.
**Why the Correct Answer is Right**
Option C, raised serum alkaline phosphatase, is incorrect because scurvy leads to decreased bone formation and mineralization, not increased. In scurvy, the body's ability to form bone is impaired, but this does not result in raised serum alkaline phosphatase levels. Instead, alkaline phosphatase levels are typically decreased in scurvy due to reduced bone turnover.
**Why Each Wrong Option is Incorrect**
**Option A:** Subperiosteal hematomas with tenderness are a true manifestation of scurvy. The lack of vitamin C leads to impaired collagen synthesis, causing blood vessel fragility and bleeding into joints and muscles.
**Option B:** Separation of epiphysis is also a true manifestation of scurvy. The impaired collagen synthesis affects bone growth and development, leading to separation of epiphyseal plates.
**Option D:** Gingival bleeding is a classic sign of scurvy, occurring due to the fragility of blood vessels and impaired collagen synthesis.
**Clinical Pearl / High-Yield Fact**
Scurvy is a disease that can occur in anyone who consumes a diet lacking in vitamin C, but it is most commonly seen in individuals who have a restricted diet, such as sailors at sea or prisoners of war.
**β Correct Answer: C. Raised serum alkaline phosphatase**