This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pharmacology
Dilantin causes? 
Select and explain. 
A. Folic acid deficiency, B. Thiamine deficiency, C. Nicotinamide deficiency, D. Riboflavin deficiency
A: Folic acid deficiency
Answer: A: Folic acid deficiency 
Explanation: Folic acid deficiency REF: KDT 7th ed p. 405 Adverse effects of phenytoin (Dilantin): At therapeutic levels At high plasma levels * * Gum hyperophy Hirsutism * Cerebellar side effects : ataxia, veigo, diplopia, nystagmus * * Hypersensitivity reactions Megaloblastic anemia due to folate deficiency * Drowsiness , behavorial alterations , hallucinations , disorientation , rigidity * Osteomalacia due to decreased in target sensitivity to * Epigastric pain vit. D * Local vascular damage may be caused by * Interferes with insulin release and hyperglycemia phenytoin * Fetal hydantoin syndrome: hypoplastic phalanges, cleft palate, hair lip, microcephaly. * Fall in BP