5-7.Use this case to answer the following questions.A 55-year-old male consulted his physician because of weakness,lightheadedness,vertigo,and angina.The patient also complained of sores on his tongue.The physical examination revealed jaundice.The pulse rate was increased,and the spleen and liver were slightly enlarged.The tongue appeared smooth and bright red in color.Family history revealed no clues.Neurological exam revealed quickening of reflex responses.Patient history indicated a total gastrectomy five years earlier for stomach cancer and intermittent heart problems that had not required surgery.The physician ordered the following tests:
-What would be the results of vitamin B₁₂ and/or folate levels in a diagnosis of pernicious anemia?
A)Increased folate
B)Increased vitamin B₁₂
C)Decreased vitamin B₁₂
D)Decreased folate and vitamin B₁₂

Question

5-7.Use this case to answer the following questions.A 55-year-old male consulted his physician because of weakness,lightheadedness,vertigo,and angina.The patient also complained of sores on his tongue.The physical examination revealed jaundice.The pulse rate was increased,and the spleen and liver were slightly enlarged.The tongue appeared smooth and bright red in color.Family history revealed no clues.Neurological exam revealed quickening of reflex responses.Patient history indicated a total gastrectomy five years earlier for stomach cancer and intermittent heart problems that had not required surgery.The physician ordered the following tests: 
-What would be the results of vitamin B₁₂ and/or folate levels in a diagnosis of pernicious anemia?
A)Increased folate 
B)Increased vitamin B₁₂ 
C)Decreased vitamin B₁₂ 
D)Decreased folate and vitamin B₁₂

Quizplus · Accepted Answer

The patient's symptoms, including weakness, lightheadedness, vertigo, sores on the tongue, and jaundice, along with the physical exam findings of an enlarged spleen and liver and a bright red tongue, are consistent with pernicious anemia. Pernicious anemia is caused by the inability to absorb vitamin B₁₂ due to the lack of intrinsic factor, which is produced by the stomach. A total gastrectomy would remove the ability to produce intrinsic factor, leading to vitamin B₁₂ deficiency. Thus, the levels of vitamin B₁₂ would be decreased in a diagnosis of pernicious anemia. Folate levels may also be decreased as they require intrinsic factor for absorption, but the primary deficiency is in vitamin B₁₂.

5-7Use This Case to Answer the Following Questions