Vitamin deficiencies and related disorders are essential topics for B. Pharm students, linking biochemical roles of vitamins to clinical presentations, diagnosis, prevention, and pharmacological management. This introduction highlights fat-soluble and water-soluble vitamins, their metabolic functions, deficiency syndromes (scurvy, rickets, beriberi, pellagra, pernicious anemia), laboratory markers, drug–nutrient interactions, recommended dietary allowances, and risks of toxicity. Understanding absorption, storage, therapeutic forms (e.g., pyridoxine, cyanocobalamin, ergocalciferol), and patient populations at risk (malabsorption, pregnancy, chronic alcohol use) prepares students for rational supplementation and counselling. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which vitamin deficiency classically causes scurvy characterized by bleeding gums and poor wound healing?
- Vitamin B1 (thiamine)
- Vitamin C (ascorbic acid)
- Vitamin D (cholecalciferol)
- Vitamin K (phylloquinone)
Correct Answer: Vitamin C (ascorbic acid)
Q2. Night blindness and xerophthalmia are earliest signs of deficiency of which vitamin?
- Vitamin A (retinol)
- Vitamin E (tocopherol)
- Vitamin B12 (cobalamin)
- Vitamin C (ascorbic acid)
Correct Answer: Vitamin A (retinol)
Q3. Which vitamin deficiency causes beriberi with peripheral neuropathy and high-output cardiac failure?
- Riboflavin (B2)
- Niacin (B3)
- Thiamine (B1)
- Pyridoxine (B6)
Correct Answer: Thiamine (B1)
Q4. Pellagra is due to deficiency of which vitamin, presenting with dermatitis, diarrhea and dementia?
- Niacin (B3)
- Folate (B9)
- Vitamin B12 (cobalamin)
- Vitamin D
Correct Answer: Niacin (B3)
Q5. Macrocytic megaloblastic anemia with hypersegmented neutrophils is most commonly caused by deficiency of which vitamin?
- Vitamin B12 (cobalamin) or Folate (B9)
- Vitamin B6 (pyridoxine)
- Vitamin K
- Vitamin A
Correct Answer: Vitamin B12 (cobalamin) or Folate (B9)
Q6. Which drug is well known to cause vitamin B6 (pyridoxine) deficiency leading to peripheral neuropathy?
- Isoniazid
- Metformin
- Warfarin
- Statins
Correct Answer: Isoniazid
Q7. Long-term metformin therapy is associated with deficiency of which vitamin causing neuropathy?
- Vitamin B12 (cobalamin)
- Vitamin D
- Vitamin C
- Vitamin E
Correct Answer: Vitamin B12 (cobalamin)
Q8. Fat malabsorption (steatorrhea) predisposes to deficiency of which vitamin group?
- Water-soluble vitamins (B and C)
- Fat-soluble vitamins (A, D, E, K)
- Trace elements (iron, zinc)
- All B vitamins only
Correct Answer: Fat-soluble vitamins (A, D, E, K)
Q9. Which vitamin’s deficiency in children leads to rickets characterized by bone deformities and growth retardation?
- Vitamin D
- Vitamin K
- Vitamin C
- Vitamin B2
Correct Answer: Vitamin D
Q10. Excessive intake of which vitamin can cause hypercalcemia, polyuria, and soft tissue calcification?
- Vitamin A
- Vitamin D
- Vitamin E
- Vitamin K
Correct Answer: Vitamin D
Q11. Poland with night blindness prevention programs commonly use supplementation of which vitamin?
- Vitamin K
- Vitamin A
- Folate (B9)
- Vitamin B6
Correct Answer: Vitamin A
Q12. A patient on prolonged broad-spectrum antibiotics develops bleeding tendency due to deficiency of which vitamin synthesized by gut flora?
- Vitamin K
- Vitamin B12
- Vitamin C
- Niacin (B3)
Correct Answer: Vitamin K
Q13. Which laboratory test is most specific for diagnosing vitamin B12 deficiency?
- Serum ferritin
- Serum methylmalonic acid (MMA)
- Serum alkaline phosphatase
- Serum folate
Correct Answer: Serum methylmalonic acid (MMA)
Q14. Which vitamin acts as a cofactor for carboxylation reactions important in coagulation cascade?
- Vitamin B6
- Vitamin K
- Vitamin D
- Vitamin C
Correct Answer: Vitamin K
Q15. Glossitis, cheilosis and seborrheic dermatitis are clinical features of deficiency of which B vitamin?
- Riboflavin (B2)
- Pyridoxine (B6)
- Thiamine (B1)
- Biotin (B7)
Correct Answer: Riboflavin (B2)
Q16. Which vitamin deficiency impairs collagen synthesis leading to fragile capillaries and poor wound healing?
- Vitamin C (ascorbic acid)
- Vitamin A
- Vitamin B12
- Vitamin E
Correct Answer: Vitamin C (ascorbic acid)
Q17. A patient with chronic cholestatic liver disease is most likely to require supplementation of which vitamin?
- Water-soluble vitamins only
- Fat-soluble vitamins, especially vitamin K and D
- Vitamin B12 only
- Vitamin C only
Correct Answer: Fat-soluble vitamins, especially vitamin K and D
Q18. Which vitamin deficiency is implicated in peripheral neuropathy, seborrheic dermatitis and microcytic anemia when severe?
- Pyridoxine (B6)
- Vitamin B12
- Niacin (B3)
- Vitamin A
Correct Answer: Pyridoxine (B6)
Q19. High-dose vitamin A teratogenicity is a concern during which period?
- Preconception only
- First trimester of pregnancy
- Lactation only
- Postmenopausal period
Correct Answer: First trimester of pregnancy
Q20. Which test helps assess vitamin D status clinically?
- Serum 25-hydroxyvitamin D
- Serum 1,25-dihydroxyvitamin D alone
- Serum calcium only
- Urinary calcium only
Correct Answer: Serum 25-hydroxyvitamin D
Q21. Which vitamin is required for transamination reactions and synthesis of neurotransmitters (e.g., serotonin, GABA)?
- Niacin (B3)
- Pyridoxine (B6)
- Folate (B9)
- Vitamin K
Correct Answer: Pyridoxine (B6)
Q22. In pernicious anemia, the underlying problem causing B12 deficiency is usually:
- Poor dietary intake of B12
- Intrinsic factor deficiency due to autoimmune gastritis
- Excessive urinary excretion of B12
- Hepatic storage failure
Correct Answer: Intrinsic factor deficiency due to autoimmune gastritis
Q23. Which vitamin deficiency may present with spinocerebellar degeneration and subacute combined degeneration of the spinal cord?
- Vitamin B12 (cobalamin)
- Vitamin B1 (thiamine)
- Vitamin E (tocopherol)
- Vitamin K
Correct Answer: Vitamin B12 (cobalamin)
Q24. Which nutritional strategy is recommended to prevent neural tube defects in newborns?
- Supplement maternal vitamin B12 only
- Supplement maternal folic acid (folate) periconceptionally
- Avoid all vitamin supplements
- High-dose vitamin A supplementation in pregnancy
Correct Answer: Supplement maternal folic acid (folate) periconceptionally
Q25. Which vitamin’s overdose leads to intracranial hypertension (benign intracranial hypertension) and alopecia?
- Vitamin A (hypervitaminosis A)
- Vitamin D
- Vitamin E
- Vitamin K
Correct Answer: Vitamin A (hypervitaminosis A)
Q26. Which vitamin is essential for carnitine synthesis and prevention of lipid peroxidation in membranes?
- Vitamin E (tocopherol)
- Vitamin C
- Vitamin B3
- Vitamin K
Correct Answer: Vitamin E (tocopherol)
Q27. Which nutritional deficiency can be aggravated by oral contraceptive use due to altered hepatic metabolism?
- Vitamin B6 and folate (B9)
- Vitamin D only
- Vitamin K only
- Vitamin C only
Correct Answer: Vitamin B6 and folate (B9)
Q28. A newborn with hemorrhagic disease is prevented by which prophylactic vitamin given at birth?
- Vitamin C injection
- Vitamin K injection
- Vitamin D oral drop
- Vitamin A topical
Correct Answer: Vitamin K injection
Q29. Which vitamin is synthesized by intestinal bacteria and contributes to clotting factor activation but may be insufficient in neonates?
- Vitamin K
- Vitamin B12
- Vitamin C
- Biotin (B7)
Correct Answer: Vitamin K
Q30. In cholestyramine therapy for hypercholesterolemia, absorption of which vitamins is impaired requiring monitoring/supplementation?
- Water-soluble vitamins only
- Fat-soluble vitamins A, D, E, K
- Only B12 and B6
- Only vitamin C
Correct Answer: Fat-soluble vitamins A, D, E, K
