This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Environment & Nutritional Pathology, Subject name: Pathology
Manganese deficiency leads to? 
Select and explain. 
A. Parkinsonism, B. Impaired skeletal growth, C. Impaired glucose tolerance, D. Anaemia
B: Impaired skeletal growth
Answer: B: Impaired skeletal growth 
Explanation: Ans. (b) Impaired skeletal growthRef: Harrison /96e-9* Manganese deficiency leads to impaired growth and skeletal development whereas toxicity leads to parkinsonism like features. Impaired glucose tolerance is seen with chromium deficiency.Deficiencies and Toxicides of MetalsElementDeficiencyToxicityManganeseImpaired growth and skeletal development, reproduction, lipid and carbohydrate metabolism; upper body rashParkinsonism like symptomsEncephalitis-like syndromeCalciumReduced bone mass, osteoporosisRenal insufficiency (milk-alkali syndrome), nephrolithiasisCopperAnemia, growth retardation, defective keratinisation and pigmentation of hair, degenerative changes in aortic elastin, osteopeniaVomiting, diarrhea, hepatic failure, tremor, mental deterioration, haemolytic anemia, renal dysfunctionChromiumImpaired glucose toleranceOccupational: Renal failure, dermatitis,FluorideT Dental cariesDental and skeletal fluorosis, osteosclerosisIodineThyroid enlargement, nF T4, cretinismThyroid dysfunction, acne-like eruptionsSeleniumCardiomyopathy, heart failure, striated muscle degenerationAlopecia, nausea, vomiting, abnormal nails, emotional lability, peripheral neuropathy, lassitude, garlic odor to breath, dermatitisOccupational: Lung and nasal carcinomasZincGrowth retardation, >1 taste and smell, alopecia, dermatitis, diarrhea, immune dysfunction, failure to thrive, congenital malformationsReduced copper absorption, gastritis, sweating, fever, nausea, vomiting