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Question: Joan Riley, age 56, came to her nurse practitioner with fatigue, pallor, dyspnea on exertion, and palpitations. Her laboratory report indicates that her hematocrit, hemoglobin, and reticulocyte count are low, that her MCV is high, and that her MCH and MCHC are normal. Her diagnosis is pernicious anemia.
Answer the following questions regarding Ms. Riley's anemia.
1. Why should Joan's nurse practitioner ask her about paresthesias and ataxia?
2. Why did her nurse practitioner prescribe vitamin B12 by intramuscular injection rather than orally?
3. What causes pernicious anemia?
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