1. A 40-year-old alcoholic male presents with confusion, ophthalmoplegia, and ataxia.
Which
vitamin deficiency is most likely responsible?
a) Thiamine
b) Niacin
c) Riboflavin
d) Pyridoxine
2. Which coenzyme form of niacin is essential for oxidative reactions in the TCA cycle?
a) FAD
b) NAD+
c) PLP
d) THF
3. A patient on isoniazid therapy develops peripheral neuropathy. Which vitamin deficiency is
the cause?
a) Thiamine
b) Pyridoxine
c) Niacin
d) Riboflavin
4. A newborn presents with severe microcytic anemia unresponsive to iron therapy. Which
vitamin deficiency should be suspected?
a) Vitamin B6
b) Vitamin B12
c) Folic acid
d) Vitamin C
5. Pellagra is characterized by which clinical triad?
a) Dermatitis, Diarrhea, Dementia
b) Dermatitis, Depression, Dyspnea
c) Diarrhea, Dysphagia, Depression
d) Dermatitis, Diabetes, Dementia
6. Which vitamin is essential for the synthesis of serotonin and GABA?
a) Vitamin B6
b) Vitamin B1
c) Vitamin B12
d) Vitamin C
7. Which vitamin acts as a coenzyme in transamination reactions?
a) Thiamine
b) Pyridoxine
c) Riboflavin
d) Niacin
8. Which of the following vitamins is essential for collagen hydroxylation?
a) Vitamin A
b) Vitamin C
c) Vitamin D
d) Vitamin E
9. Which clinical feature is most specific for riboflavin deficiency?
a) Cheilosis and angular stomatitis
b) Glossitis and pellagra
c) Peripheral neuropathy
d) Night blindness
10. Which vitamin is an integral component of coenzyme A?
a) Pantothenic acid
b) Biotin
c) Thiamine
d) Niacin
11. Which vitamin deficiency results in subperiosteal hemorrhages and impaired wound
healing?
a) Vitamin A
b) Vitamin C
c) Vitamin D
d) Vitamin K
12. Which vitamin deficiency leads to megaloblastic anemia with neurologic symptoms?
a) Folic acid
b) Vitamin B12
c) Niacin
d) Vitamin B6
13. Which of the following vitamins is stored in the liver in significant amounts for years?
a) Vitamin B12
b) Vitamin C
c) Thiamine
d) Biotin
14. Which vitamin is essential for methylation reactions, including the conversion of
homocysteine to methionine?
a) Vitamin B6
b) Vitamin B12
c) Niacin
d) Riboflavin
15. Which vitamin deficiency is associated with neural tube defects in the fetus?
a) Vitamin A
b) Vitamin B12
c) Folic acid
d) Biotin
16. Which vitamin is essential for phototransduction in the retina?
a) Vitamin A
b) Vitamin C
c) Vitamin D
d) Vitamin E
17. A patient presents with hemolytic anemia and peripheral neuropathy. Which vitamin
deficiency is most likely?
a) Vitamin K
b) Vitamin E
c) Vitamin D
d) Vitamin A
18. Which fat-soluble vitamin deficiency causes impaired blood clotting and increased
prothrombin time?
a) Vitamin A
b) Vitamin D
c) Vitamin E
d) Vitamin K
19. Which vitamin acts as a cofactor for carboxylation reactions?
a) Biotin
b) Thiamine
c) Riboflavin
d) Folic acid
20. Which vitamin is required for pyruvate dehydrogenase and α-ketoglutarate
dehydrogenase complexes?
a) Vitamin B12
b) Vitamin B1
c) Niacin
d) Pantothenic acid
21. Which vitamin deficiency causes microcytic anemia due to impaired heme synthesis?
a) Vitamin B6
b) Vitamin B12
c) Folic acid
d) Niacin
22. Which vitamin deficiency causes seborrheic dermatitis and alopecia?
a) Biotin
b) Pantothenic acid
c) Riboflavin
d) Vitamin B6
23. Which vitamin is required for γ-carboxylation of glutamic acid residues in clotting factors?
a) Vitamin K
b) Vitamin C
c) Vitamin D
d) Vitamin E
24. Which vitamin deficiency is most likely in a patient on chronic warfarin therapy?
a) Vitamin A
b) Vitamin K
c) Vitamin D
d) Vitamin E
25. Which vitamin deficiency can cause both dermatitis and diarrhea but no dementia?
a) Vitamin C
b) Riboflavin
c) Niacin
d) Biotin
26. Which vitamin is essential for the conversion of tryptophan to niacin?
a) Vitamin B6
b) Vitamin C
c) Vitamin B12
d) Vitamin A
27. Which vitamin deficiency can occur in prolonged total parenteral nutrition without
supplementation?
a) Vitamin B12
b) Vitamin C
c) Biotin
d) Vitamin E
28. Which vitamin deficiency is associated with excessive raw egg white consumption?
a) Riboflavin
b) Biotin
c) Niacin
d) Thiamine
29. Which vitamin is essential for preventing oxidative damage to RBC membranes?
a) Vitamin C
b) Vitamin E
c) Vitamin K
d) Vitamin D
30. Which vitamin deficiency in a vegan mother can lead to megaloblastic anemia and
neurological defects in the infant?
a) Vitamin A
b) Vitamin C
c) Vitamin B12
d) Folic acid
1. A patient with chronic diarrhea presents with metabolic acidosis. Which electrolyte
abnormality is most likely?
a) Hyperkalemia
b) Hypokalemia
c) Hypernatremia
d) Hypercalcemia
2. Which of the following changes is most characteristic of hypocalcemia on ECG?
a) Short QT interval
b) Prolonged QT interval
c) ST elevation
d) Flattened T waves
3. A 55-year-old man with congestive heart failure is started on furosemide. Which
electrolyte disturbance is most likely to occur?
a) Hyperkalemia and metabolic alkalosis
b) Hypokalemia and metabolic alkalosis
c) Hyperkalemia and metabolic acidosis
d) Hyponatremia and metabolic acidosis
4. Which mechanism primarily regulates potassium secretion in the distal nephron?
a) Aldosterone-mediated Na⁺ reabsorption
b) ADH secretion
c) Plasma osmolarity
d) Parathyroid hormone
5. A patient presents with muscle weakness and ECG shows flattened T waves and
prominent U waves. Which is the likely diagnosis?
a) Hyperkalemia
b) Hypokalemia
c) Hypercalcemia
d) Hyponatremia
6. Which of the following electrolyte imbalances is most strongly associated with digoxin
toxicity?
a) Hypernatremia
b) Hyperkalemia
c) Hypokalemia
d) Hypercalcemia
7. Which diuretic is most likely to cause hyperkalemia?
a) Furosemide
b) Hydrochlorothiazide
c) Spironolactone
d) Acetazolamide
8. A patient with chronic kidney disease develops torsades de pointes. Which electrolyte
abnormality is most likely responsible?
a) Hypermagnesemia
b) Hypomagnesemia
c) Hyperchloremia
d) Hypernatremia
9. Which condition is most commonly associated with metabolic alkalosis?
a) Diarrhea
b) Vomiting
c) Renal failure
d) Lactic acidosis
10. Which electrolyte abnormality is most likely after prolonged vomiting?
a) Hyponatremia and metabolic acidosis
b) Hypokalemia and metabolic alkalosis
c) Hyperkalemia and metabolic acidosis
d) Hypercalcemia and metabolic alkalosis
11. A patient presents with muscle twitching, positive Chvostek sign, and prolonged QT
interval. Which electrolyte abnormality is likely?
a) Hyperkalemia
b) Hypocalcemia
c) Hypercalcemia
d) Hyponatremia
12. Which of the following conditions predisposes most strongly to ventricular fibrillation?
a) Hyperkalemia >7 mmol/L
b) Hypernatremia >160 mmol/L
c) Hypocalcemia
d) Hypermagnesemia
13. Which hormone is most important for maintaining plasma calcium levels?
a) Calcitonin
b) Aldosterone
c) Parathyroid hormone
d) Cortisol
14. A patient with Addison’s disease is found to have ECG changes suggestive of
hyperkalemia. Which change is typical?
a) Flattened T wave
b) Tall peaked T waves
c) ST depression
d) U waves
15. Which electrolyte change causes increased neuromuscular excitability and tetany?
a) Hyperkalemia
b) Hypocalcemia
c) Hypermagnesemia
d) Hypernatremia
16. Which is the most important buffer system in maintaining plasma pH?
a) Protein buffer
b) Hemoglobin buffer
c) Bicarbonate buffer
d) Ammonia buffer
17. In respiratory acidosis, what is the compensatory response?
a) Increased renal H⁺ secretion and HCO₃⁻ reabsorption
b) Decreased renal H⁺ secretion and HCO₃⁻ reabsorption
c) Increased ventilation
d) Increased bicarbonate excretion
18. Which drug can cause hyperkalemia by inhibiting aldosterone’s action on the distal
nephron?
a) Furosemide
b) Spironolactone
c) Hydrochlorothiazide
d) Mannitol
19. Which electrolyte abnormality is commonly seen in tumor lysis syndrome?
a) Hypokalemia, hypophosphatemia
b) Hyperkalemia, hyperphosphatemia
c) Hypernatremia, hypercalcemia
d) Hypocalcemia, hypokalemia
20. Which ECG finding is most characteristic of severe hyperkalemia?
a) Prolonged PR interval and flattened T wave
b) Tall peaked T waves and widened QRS
c) Short QT interval and U waves
d) Prominent P waves and ST elevation
