Medicine (Block 1) MCQ 2/40

A 50-year-old male underwent a partial gastrectomy for the treatment of gastric ulcers a decade ago. During examination, he displays pallor, and his hemoglobin (Hb) level is measured at 8 g/dL. His mean corpuscular hemoglobin concentration (MCHC) value is within the normal range, but his mean corpuscular volume (MCV) value is elevated. What is the most appropriate treatment option?

A. Vitamin K
B. Iron supplements
C. Inj. B12
D. Vitamin C tablets
E. High protein diet

Answer: The most appropriate treatment option for the 50-year-old male with a history of partial gastrectomy, pallor, low hemoglobin (Hb) level (8 g/dL), normal mean corpuscular hemoglobin concentration (MCHC) value, and increased mean corpuscular volume (MCV) value is C) Inj. B12 (Vitamin B12 injections).

A partial gastrectomy can result in impaired absorption of vitamin B12, leading to a condition known as pernicious anemia. This is characterized by macrocytic anemia, elevated MCV, and low Hb levels. Treatment involves supplementation of vitamin B12, often via injections, to bypass the impaired absorption.

Options such as Vitamin K (A), Iron supplements (B), and High protein diet (E) would not address the underlying cause of the macrocytic anemia seen in this patient. Vitamin C tablets (D) are not indicated for the treatment of macrocytic anemia, or the nutritional deficiency associated with a partial gastrectomy.