QUESTION 2 Thoriq, a 15-year-old vegetarian boy presented with easy fatigue, and breathlessness during the past few week

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Question 2 Thoriq A 15 Year Old Vegetarian Boy Presented With Easy Fatigue And Breathlessness During The Past Few Week 1 (60.83 KiB) Viewed 10 times

QUESTION 2 Thoriq, a 15-year-old vegetarian boy presented with easy fatigue, and breathlessness during the past few weeks. Paleness and icterus (jaundice) in the sclerae had been noted by the parents for about 2 years, although these findings became more obvious within the last few weeks. The vegetarian patient had not consumed any food of animal origin for many years. Besides, the family only rarely ate fresh fruits or vegetables. In the physical examination, the patient looked pale and weak, and his sclerae were icteric. His heart rate was 110 bpm (tachycardiac), peripheral blood smear (as shown in the figure below) indicates severe macrocytic anaemia, haemoglobin, 5.1 g/dL (12.5g/dl - 18.0g/dl); mean corpuscular volume, 116 fL (80-100 fl) in addition to leucopenia and thrombocytopenia (pancytopenia), and serum vitamin B12 (cobalamin) levels were 58 pg/mL (211-911 pg/mL). Anti-intrinsic factor (anti-IF) and antiparietal cell antibodies test came out positive. Bone marrow aspiration study demonstrated macromegaloblastic erythropoiesis and ruled out leukaemia. (10 Points) UNIVERSITY OF AVA macrocytes Poor 3₂% a) Based on the laboratory investigation, state the BEST possible diagnosis for Thoriq. (1 mark) (1 mark) (2 marks) b) Referring to the figure, determine P. c) State the possible causes of Thoriq's disease.
UNIVERSITY OF a) Based on the laboratory investigation, state the BEST possible diagnosis for Thoriq. (1 mark) b) Referring to the figure, determine P. (1 mark) c) State the possible causes of Thoriq's disease. (2 marks) d) State FOUR (4) laboratory investigations that made you decide on the diagnosis made in (a). (4 marks) (2 marks) e) State TWO (2) possible treatments for his disease.