Hypervitaminosis/hypovitaminosis: The Daily PANCE Blueprint

Home Hypervitaminosis/hypovitaminosis: The Daily PANCE Blueprint

Hypervitaminosis/hypovitaminosis: The Daily PANCE Blueprint

A 42-year-old female with a history of GERD and Crohn's disease presents to your clinic. About a year ago she had her ileum resected. This patient is now most likely to have which of the following clinical features?

A. Hyporeflexia and tremors
B. Headaches and fatigue
C. Oral ulcers and bleeding
D. Koilonychia
E. Ataxia and peripheral neuropathy

Answer and topic summary

The answer is E. Ataxia and peripheral neuropathy

Vitamin B12 is a vitamin needed for myelination of the body’s nervous system, as well as for red blood cell production. People can become deficient in B12 due to many reasons: atrophic gastritis, gastrectomy, alcohol use disorder, Crohn’s disease, pancreatic insufficiency, anorexia, strict vegan diets, and drugs (PPI, metformin, etc). Remember, the ileum is the major site of absorption of vitamin B12. Clinical features may include fatigue, pallor, peripheral neuropathy, gait abnormalities, depression, dementia, glossitis, etc. Remember, both homocysteine and methylmalonic acid are elevated in B12 deficiency. Treatment is IM supplementation of vitamin B12.

View blueprint lesson

Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint GI and Nutrition ⇒ Nutritional and vitamin disorders ⇒ Hypervitaminosis/hypovitaminosis

Also covered as part of the Internal Medicine EOR and topic list

Sign up for the ENTIRE Blueprint Daily Email Series (500 days and counting! 😀)

Sign Up
X