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Review Question - QID 1104

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QID 1104 (Type "1104" in App Search)
Vitamin B12 deficiency is a known cause of which the following?

Inability to whistle

0%

12/3954

Peripheral sensory neuropathy

96%

3801/3954

Increased deep tendon reflexes

3%

109/3954

Urinary retention

0%

8/3954

Hydrophobia

0%

7/3954

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Vitamin B12 deficiency is a known cause of peripheral sensory neuropathy and B12 levels should be evaluated in patients presenting with peripheral sensory neuropathy. It is associated with decreased deep tendon reflexes, pathologic reflexes like Babinski's sign, and fatigue/depression. The inability to whistle is associated with fascioscapular dystrophy. Hydrophobia is associated with rabies infection.

Smith and Singleton evaluated 138 patients referred with predominantly sensory symptoms to identify a standardized approach to diagnosis. They recommend that patients be tested for glucose tolerance and vitamin B(12) concentration in all cases, but that other tests should be performed only when the clinical scenario is suggestive.

Steiner et al. describe a case report of a patient with vitamin B12 sensory peripheral neuropathy and associated EMG evidence of nerve demyelination as the potential cause for the observed clinical symptoms.

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