Tiff
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A 70 year old man with no prior surgical history presents with numbness/tingling of the extremities, weakness, and glossitis. Preliminary laboratory studies are negative for antinuclear antibodies and antimitochondrial antibodies, but positive for anitbodies against instrinsic factor. What is the function of the protein that is deficient and/or affected in this disease process?
A. Binding free vitamin B12 in ileal cells for transport through the boodstream
B. Binding free vitamin B12 in the small intestine and then to ileal receptors
C. Binding free vitamin B12 in the stomach
D. Splitting R-protein/vitamin b12 complexes in the duodenum
E. Splitting vitamin B12 from its exogenous ingested protein-bound form.
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| GoodGirl
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B
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| jean robert
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C
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| angel23
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B
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| Idlehands
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B. Binding free vitamin B12 in the small intestine and then to ileal receptors
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| new_n_lost
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B. Binding free vitamin B12 in the small intestine and then to ileal receptors
ref Papi pg 208-209
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| Tiff
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 . The correct answer is B. Clinical and laboratory findings are consistent with pernicious anemia, a chronic progressive anemia that is caused by a failure to absorb vitamin B12 because of a lack of availability of intrinsic factor. It is believed to be caused by immune-mediated destruction of gastic mucosa, leading to a loss of parietal cells. Several studies have also suggested that autoanitbodies may play a role by blocking the binding of vitamin B12 to intrisnic factor, preventing the binding of instinsic factor or instrinsic factor/vitamin B12 complex to receptors in the ileum of the intestine, or attacking the gastric proton pumps of parietal cells. The normal physiologic function of instrinsic factor is to bind free vitamin B12 in the small intestine and bind the resulting complex to receptors on cells on the ileum of the intestine.
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| Ig F
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b......IF released by astric parietal cells bind free Vit B 12 and carry it to the ileal cells for absorbtion.....
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