A vegan patient has macrocytic anaemia, numbness of the feet and loss of vibration sense, with a low serum B12. Why should folic acid not be given alone?
Answer and explanation
Correct answer: D. It can correct the anaemia while the neuropathy progresses
- Step 1: Vitamin B12 deficiency has haematological and neurological consequences. Step 2. Folate corrects the megaloblastic changes but does not treat the neuropathy, which can worsen, so B12 replacement is given first or together. Answer: It can correct the anaemia while the neuropathy progresses. Why not the others: Folic acid does not cause haemolysis. It has no effect on iron stores. It is indicated in folate-deficiency macrocytosis.
Practise more Haematology.
Free questions with an explanation for every one, and full timed UKMLA Applied Knowledge Test (MSRA-style single best answer) mock tests.
More Haematology questions
- A 62-year-old man has iron-deficiency anaemia on a routine blood test, with no symptoms. What is the most important next step?
- A child with sickle cell disease has severe bone pain, fever and a hot swollen limb. Which organism is the characteristic cause of osteomyel…
- A patient receiving chemotherapy has a temperature of 38.5 degrees Celsius and a neutrophil count of 0.3 x 10^9/L. According to NICE, how qu…
- A woman has fever, confusion, microangiopathic haemolytic anaemia, thrombocytopenia and renal impairment. What is the correct management?
- According to NICE, what haemoglobin threshold may be considered for red cell transfusion in a patient without acute coronary syndrome or maj…
- A middle-aged patient has leucocytosis, splenomegaly and the Philadelphia chromosome. Which fusion gene is present and which drug class is f…