doc_clotaire
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A 34 yo male who recently emigrated from Asia come to the clinic and complains of 2 months hystory of exertional shortness of breath and easy fatigability . He has been taking Isionazid and Rifampin for his tuberculosis which was diagnosed 4 months ago . Due to his religious belief , he completely turned into a vegeterian for the last year . Physical examination reveals pallor . Peripheral smear shows macrocytosis with hypersegmented polymorphonuclear neutrofil . His WBC and platelet count are within normal . This patient 's most likely problem is due to which of the following ?
a ) Vit B12 deficiency because of the vegeterian diet
b ) Vit B12 deficiency because of pernicious anemia
c ) Drug -induced B12 deficiency
d ) Myelodysplastic syndrome
e ) Chronic Myeloid Leukemia
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| jean robert
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B (mcc of vit B12 deficiency.....megaloblastic anemia)
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| hope4dabest
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B...
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| PGI2alpha
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A? i feel its dietary...
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| arlete
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A
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| SURVIVOR
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B.
cant be A i think cuz our liver has over 5 years of storage for Vi B12. This guy has just a ONE year history!
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| new_n_lost
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b ) Vit B12 deficiency because of pernicious anemia
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| doc_clotaire
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B )Vit B12 deficiency because of pernicious anemia
The most likely diagnosis is Vitamin B12 deficiency due to pernicious anemia , which is an autoinmune disease resulting from the destruction of parietal cell . The nest step in management of this patient is measurement of the intrinsic factor antibody titer and B12 levels
( Choice A ) A stric vegeterian diet can cause B12 deficiency , however the total body Vit B12 are depleted slowly and can usually last for 3 to 4 years after starting such a diet . This patient has been on a vegeterian diet for only one year , therefore , a diet related B12 deficiency is very unlikely .
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| SURVIVOR
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| arlete
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What supplement do we give when treating tuberculosis? Is it vitamin B6 or folic acid?
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| SURVIVOR
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B6
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| arlete
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Thank you, I forgot.
Doc_clotaire, thanks for the question. Always good to keep our memories fresh!
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