Rohit, aged 15 years, complains of bleeding gums. The nurse will advise him to take a diet high in?

JODHPUR AIIMS SNO-2018

Applied Nutrition & Dietetics

Easy

Appeared in: JODHPUR AIIMS SNO-2018

Explanation

Bleeding gums are a hallmark sign of Vitamin C deficiency, a condition called scurvy.
Vitamin C is essential for collagen synthesis, a protein that maintains the integrity and strength of connective tissues, including the walls of capillaries in the gums.
A lack of Vitamin C leads to fragile capillaries that rupture easily, causing spontaneous bleeding, especially from the gums.
Advising a diet high in Vitamin C-rich foods like citrus fruits, amla, and green vegetables directly addresses the underlying cause of the symptom.

Option B: While Vitamin B complex deficiencies can cause oral symptoms like a sore tongue (glossitis) or cracks at the corners of the mouth (angular cheilitis), they are not the primary cause of bleeding gums.
Option C: Vitamin A deficiency primarily affects vision (night blindness), immune function, and the health of skin and epithelial tissues. It is not directly associated with bleeding gums.
Option D: Vitamin D is crucial for calcium absorption and bone health. Its deficiency leads to conditions like rickets in children and osteomalacia in adults, characterized by weak and painful bones, not bleeding gums.

Clinical Relevance

Nursing practice connection: Use the key finding related to Nutritional deficiencies and their clinical manifestations to guide bedside assessment, documentation, and the next nursing action.
Nurses must be adept at nutritional screening. Recognizing bleeding gums as a potential sign of scurvy allows for timely dietary intervention and patient education, preventing more severe complications.
In the Indian context, nurses can recommend affordable and locally available Vitamin C sources like amla (Indian gooseberry), guava, lemons, and seasonal green leafy vegetables.
What if? If the 15-year-old was also a strict vegan, the nurse should also assess for potential Vitamin B12 deficiency, which can cause anemia and neurological problems, although it doesn't typically cause bleeding gums.

How to Approach the Question

First, identify the key clinical finding in the question: 'bleeding gums' in a 15-year-old.
Second, systematically review the functions and deficiency signs of each vitamin listed in the options.
Third, directly link the symptom 'bleeding gums' to its most well-known cause among the choices. This is a classic sign of scurvy, which is caused by Vitamin C deficiency.
Fourth, eliminate the other options by confirming their primary deficiency symptoms are different. Vitamin A relates to vision, Vitamin D to bones, and Vitamin B complex to issues like glossitis or cheilosis.
Finally, select the option that directly addresses the patient's primary complaint.

Concept Tested & Keywords

Concept Tested: Nutritional deficiencies and their clinical manifestations.
Stem keywords: bleeding gums, 15 years, diet high in
Lead-in keywords: advise
Clinical cues: Bleeding gums in an adolescent is a significant clinical sign pointing towards a potential dietary deficiency.

QAPzHrP2cDjU9VGItm6zoc

E6 textbook of Applied Biochemistry and Nutrition & DieteticsHarbans Lal (pp 26-464 of 479) p. 370-372

E6 Textbook of Biochemistry for medical StudentsDM Vasudevan Part 2 — Subpart A (pp 1-239 of 478) p. 154-156

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 513-515