Page 1 of 1: classic presentation

drlouis · Credits: 5374 My Scrapbook

An 80-year-old man who had a hemicolectomy for colon cancer is evaluated because of a 4-month history of diarrhea, anorexia, and fatigue. He had a remote history of alcoholism.On physical examination, he is cachectic and mildly confused. Neurologic examination shows loss of position sense in the feet. He has a wide-based gait. The Romberg test is positive.Which of the following is the most likely cause for his symptoms?
( A ) Alcoholic cerebellar degeneration
( B ) Vitamin B12 deficiency
( C ) Brain metastases
( D ) Folate deficiency
( E ) Liver metastases

BRAVO · Credits: 45736 My Scrapbook

Vitamin B12 deficiency

drlouis · Credits: 5374 My Scrapbook

other related features includes increased MCV and bald,sore tongue and increased unconjugated bilirubin due to ineffective erythropoiesis.

in a young man,pure vegeterian and celiac sprue and chrons disease must be considered.

associated pernicious anemia should be considered in a pt with either thyroid disorder or diabetic individual.

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