2nd July 2023

A 40-year-old man with no fixed abode was brought to A&E with a five-week history of diarrhoea

A 40-year-old man with no fixed abode was brought to A&E with a five-week history of diarrhoea. He is also confused and lethargic. On initial assessment:

A – patent

B – oxygen saturations 98% on 2L O2, chest clear with equal expansion

C – capillary refill time – sluggish, BP 110/70, HR 90 and regular

D – blood glucose 5, GCS: E4 V4 M6, temperature 37°C

E – well-demarcated necklace-like erythematous rash around the neck, upper chest and arms

Which vitamin is this patient most likely to be deficient in?

Select the SINGLE most appropriate option from the list below. Select ONE option only.