Which nutritional deficiency could be associated with the patient's chief complaint?

• A. Vitamin B12
• B. Vitamin C
• C. Iron
• D. Vitamin D

Answer: (A)

Vitamin B12 deficiency often shows up in the mouth with changes in the oral mucosa and sensation. B12 is essential for DNA synthesis and the rapid turnover of epithelial cells, so when it’s deficient, the tongue and other oral tissues can become atrophic and inflamed. A common finding is glossitis—the tongue becomes smooth, red, and tender, sometimes with a burning sensation or altered taste. Neurological symptoms like numbness or tingling can also accompany oral symptoms because B12 deficiency can affect nerve myelination.

If the patient’s chief complaint involved a painful, sore, or smooth “beefy” red tongue or burning mouth, that pattern fits vitamin B12 deficiency well. By contrast, vitamin C deficiency would more likely cause gingival bleeding and swelling; iron deficiency often presents with pallor and angular cheilitis; vitamin D deficiency is less commonly tied to specific oral mucosal signs. So the oral clues in this case point most strongly to a B12 deficiency.