Rosh Review Practice Questions and Answers | 100% Pass
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Course
ROSH
Institution
ROSH
Rosh Review Practice Questions and
Answers | 100% Pass
Which of the following patients is at greatest risk of developing West Nile
meningoencephalitis?
22-year-old man status postrenal transplant
3-year-old girl who is unvaccinated
58-year-old man with diabetes and hypertension
82-year-old w...
Vitamin B12 elevation - Answer✔️✔️-Correct Answer ( B )
Explanation:
Vitamin B12 is found in animal products and binds to intrinsic factor (IF) secreted by
gastric parietal cells. This complex is absorbed in the terminal ileum. Pernicious anemia
is an autoimmune disorder in which antibodies act against intrinsic factor and gastric
parietal cells leading to chronic atrophic gastritis and decreased production and function
of intrinsic factor. This subsequently leads to vitamin B12 deficiency. In vitamin B12
deficiency, serum methylmalonic acid is increased. In elderly patients, this form of
megaloblastic anemia is one of the leading causes of vitamin B12 deficiency. Pernicious
anemia is associated with other immunologic diseases such as Sjögren's syndrome,
Hashimoto's disease, type 1 diabetes mellitus, and celiac disease. It is also associated
with an increased risk for gastric cancer and carcinoid tumors. Vitamin B12 deficiency
caused by dietary deficiency or malabsorption is rare. Dietary causes of deficiency are
limited to elderly people who are already malnourished. Since the 1980s, the
malabsorption of vitamin B12 has become rare, due to the decreasing frequency of
gastrectomy and surgical resection of the terminal small intestine Other disorders
associated with vitamin B12 malabsorption include deficiency in the exocrine function of
the pancreas after chronic pancreatitis (usually alcoholic), lymphomas or tuberculosis of
the intestine, Crohn's disease, Whipple's disease, and celiac disease. Uncommon
etiology also includes nitrous oxide anesthesia and abuse.
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