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    Case Study Vit B12

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    Quincey Hamilton
    The patient has several risk factors that have likely contributed to vitamin B12 deficiency, including a history of alcohol and cocaine use since age 17, poor nutrition, and frequent use of famotidine. Clinical symptoms observed in the patient include paresthesias, pallor, glossitis, mild memory impairment, weakness, slowed response time, and unsteady gait. Signs detected include those symptoms as well as a systolic murmur, bowel sounds, tongue protrusion, sensory deficits, and laboratory findings consistent with vitamin B12 deficiency. The patient has megaloblastic anemia and neurologic abnormalities, indicating a diagnosis of pernicious anemia caused by vitamin B12 deficiency.

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    Case Study Vit B12

    Uploaded by

    Quincey Hamilton
    457 views3 pages
    The patient has several risk factors that have likely contributed to vitamin B12 deficiency, including a history of alcohol and cocaine use since age 17, poor nutrition, and frequent use of famotidine. Clinical symptoms observed in the patient include paresthesias, pallor, glossitis, mild memory impairment, weakness, slowed response time, and unsteady gait. Signs detected include those symptoms as well as a systolic murmur, bowel sounds, tongue protrusion, sensory deficits, and laboratory findings consistent with vitamin B12 deficiency. The patient has megaloblastic anemia and neurologic abnormalities, indicating a diagnosis of pernicious anemia caused by vitamin B12 deficiency.

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    The patient has several risk factors that have likely contributed to vitamin B12 deficiency, including a history of alcohol and cocaine use since age 17, poor nutrition, and frequent use of famotidine. Clinical symptoms observed in the patient include paresthesias, pallor, glossitis, mild memory impairment, weakness, slowed response time, and unsteady gait. Signs detected include those symptoms as well as a systolic murmur, bowel sounds, tongue protrusion, sensory deficits, and laboratory findings consistent with vitamin B12 deficiency. The patient has megaloblastic anemia and neurologic abnormalities, indicating a diagnosis of pernicious anemia caused by vitamin B12 deficiency.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    457 views3 pages

    Case Study Vit B12

    Uploaded by

    Quincey Hamilton
    The patient has several risk factors that have likely contributed to vitamin B12 deficiency, including a history of alcohol and cocaine use since age 17, poor nutrition, and frequent use of famotidine. Clinical symptoms observed in the patient include paresthesias, pallor, glossitis, mild memory impairment, weakness, slowed response time, and unsteady gait. Signs detected include those symptoms as well as a systolic murmur, bowel sounds, tongue protrusion, sensory deficits, and laboratory findings consistent with vitamin B12 deficiency. The patient has megaloblastic anemia and neurologic abnormalities, indicating a diagnosis of pernicious anemia caused by vitamin B12 deficiency.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 3

    Tosha Kight

    Case Study 90
    Vitamin B12 Deficiency Anemia

    Patient Case Question #1:


    Identify three major risk factors that have likely contributed to a vitamin B12 deficiency state in the
    patient.
    #1: Excessive use of alcohol and cocaine since age 17
    #2: Long history of poor nutrition
    #3: Use of OTC famotidine “almost every day” for the past 2 years for heartburn.

    Patient Case Question #2:


    Clinical symptoms are subjective expressions of disease that can only be reported by the patient.
    Identify a minimum of eight symptoms in the case study above that are consistent with a diagnosis of
    vitamin B12 deficiency.
    #1: (+) paresthesias, upper and lower extremities bilaterally
    #2: Pallor with mild jaundice
    #3: Beefy- red tongue consistent with glossitis
    #4: Mini- mental exam 25/30 (recent memory was mildly impaired)
    #5: Mild 4/5 weakness of iliopoas muscle on right side
    #6: Response time was somewhat slow
    #7: Unsteady with eyes closed
    #8: Slow, cautions, unsteady, and wide based

    Patient Case Question #3:


    Clinical signs are objective expressions of disease that can be detected by someone other than the
    patient. Identify a minimum of fifteen signs in the case study about that are consistent with a diagnosis
    of vitamin B12 deficiency.
    #1: Excessive use of alcohol and cocaine since age 17
    #2: Long history of poor nutrition
    #3: Use of OTC famotidine “almost every day” for the past 2 years.
    #4: Pallor with mild jaundice
    #5: Beefy- red tongue consistent with glossitis
    #6: Systolic murmur heard best at right sternal border
    #7: Positive bowel sounds
    #8: response time was somewhat slowed
    #9: Mini- mental exam 25/30 (recent memory was mildly impaired)
    #10: XII tongue protruded mid- line
    #11: Mild 4/5 weakness of iliopsoas muscle on right side
    #12: Diminished pinprick and temperature sensations in stocking and glove distribution
    #13: Sense of vibration lost in both lower extremities from knees down
    #14: Unsteady with eyes closed
    #15: Slow, cautious, unsteady, and wide based
    Patient Case Question #4:
    Identify a minimum of twelve laboratory blood test findings that are consistent with a diagnosis of
    vitamin B12 deficiency.
    #1: Vitamin B12
    #2: Folic acid
    #3: MMA
    #4: Homocysteine
    #5: RBC
    #6: WBC
    #7: Retic
    #8: Hematocrit
    #9: Hemglobin
    #10: Indirect Bilirubn
    #11: MCV
    #12: Platelet count

    Patient Case Question #5:


    Identify ALL abnormal laboratory blood test findings in table 90.2 that are not necessarily specific for a
    vitamin B12 deficiency.
    #1: Cl
    #2: Hb
    #3: Hct
    #4: RBC
    #5: Plt
    #6: WBC
    #7: Retic
    #8: MCV
    #9: MCH
    #10: Vit B12
    #11: T Bilirubin
    #12: Bilirubin, indirect
    #13: Alb
    #14: T protien
    #15: MMA
    #16: Homocysteine

    Patient Case Question #6:


    Is the patient renal function normal or abnormal?
    -Alb (albumin) is abnormal = 3.0 g/dL normal level is 3.5-5.5 g/dL

    Patient Case Question #7:


    Is the patients hepatic function normal or abnormal?
    -AST and ALT are normal

    Patient Case Question #8:


    Is the patients lipid profile normal or abnormal?
    -TChol, HDL, LDL, and Trig are all normal
    Patient Case Question #9:
    Does this patient have pernicious anemia? Briefly explain your answer.
    -Yes! On the peripheral blood smear the patient had macrocyclic red blood cells which is
    pernicious anemia that is caused by vitamin B12 deficiency.

    Patient Case Question #10:


    The patient in this case study has…
    A. Megaloblastic anemia
    B. Neurologic abnormalities
    C. Both A and B
    D. None of the above
    -C. Both A and B

    Patient Case Question #11:


    What is the medical terminology that s used for “neck pain shooting down the back and into the arms”
    and what is the significance of this patients complaints?
    -Cervical rediculopathy caused by inflammation

    Patient Case Question #12:


    What is causing this patients so- called slapping gait?
    -The neurological deficiencies caused from the vitamin B12

    Patient Case Question ##13:


    What is the significance of the Romberg test in this patient?
    -This is a test of the body’s sense of positioning that requires a healthy functioning of the dorsal
    columns of the spinal cord. It helps to determine if this patient has any sort of neurological
    abnormalities.

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