A 61yo man underwent a surgery in which ileal resection had been done. He complains of
fatigue, headache, and heart racing. Labs: MCV=108fL, Hgb=8.9g/dL. What is the most likely dx?
a. Vit B12 def
b. Iron def
c. Folate def
d. Hemolytic anemia
e. Anemia of chronic disease
Q. 1. What is the key?
Q. 2. What are the points in favour?
Ans. 1. The key is Vit. B12 deficiency.
Ans. 2. Vit B12 is absorbed mostly in ileum. [As ileal resection is done B12 is not absorbed leading to megaloblastic anaemia].