American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which deficiency can lead to sideroblastic anemia and peripheral neuropathy?

1. Cobalamin deficiency

2. Folate deficiency

3. Pyridoxine deficiency

4. Zinc deficiency

The correct answer is: Pyridoxine deficiency

Sideroblastic anemia is a type of anemia characterized by the bone marrow's inability to properly incorporate iron into hemoglobin despite having adequate levels of iron. One important factor involved in this process is pyridoxine, or vitamin B6, which is essential for heme synthesis. A deficiency in pyridoxine disrupts this process, leading to the formation of ringed sideroblasts in the marrow and resulting in sideroblastic anemia. In addition to its role in hematopoiesis, pyridoxine is crucial for the proper functioning of peripheral nerves. A deficiency can lead to neurological symptoms due to its involvement in the synthesis of neurotransmitters and maintenance of the nervous system. Therefore, a lack of pyridoxine can manifest as both sideroblastic anemia and peripheral neuropathy. The other options, while they may lead to certain types of anemia or neurological issues, do not specifically cause both sideroblastic anemia and peripheral neuropathy in the same way that pyridoxine deficiency does. Cobalamin (vitamin B12) deficiency typically leads to macrocytic anemia and neurological symptoms, but not sideroblastic anemia. Folate deficiency is also associated with macrocytic anemia and does not cause peripheral neuropathy