A 56yo woman is known case of pernicious anemia. She refuses to take hydroxycobalamin IM as
she is needle shy. She asks for oral medication. Why will oral meds be not effective?
a. Intrinsic factor def
c. Irritated gastric mucosa
d. Lack of gastric acidity
Ans. The key is A. Intrinsic factor def. [Vitamin B12 cannot be absorbed without intrinsic factor].