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Pathology · single question

A patient with a 20-year history of scurvy presents with gingival bleeding and periodontal breakdown. What is the underlying cause?

  1. A platelet production defect
  2. Excessive vitamin K intake
  3. Bacterial overgrowth alone
  4. Nutritional deficiency of vitamin C impairing collagen synthesis
Show answer and explanation

Correct answer: D. Nutritional deficiency of vitamin C impairing collagen synthesis

  • A. Platelet count is normal in scurvy; the bleeding is from vascular fragility, not thrombocytopenia.
  • B. Vitamin K excess is unrelated; vitamin K DEFICIENCY affects clotting factors II, VII, IX, X.
  • C. Plaque bacteria drive the inflammation, but the deficiency is what makes the tissue break down so severely — it is the underlying cause here.
  • D. Correct. Scurvy is VITAMIN C (ascorbic acid) deficiency. Ascorbate is an essential cofactor for prolyl and lysyl hydroxylase, the enzymes that hydroxylate proline and lysine in procollagen. Without it, collagen triple helices are unstable — producing fragile capillaries, defective periodontal ligament and connective tissue, swollen hemorrhagic gingiva, perifollicular hemorrhage, poor wound healing, and tooth mobility.

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