Question

A 72-year-old vegan woman presents with progressive paraesthesia and gait instability. Labs show haemoglobin 100 g/L, MCV 108 fL, low vitamin B12 level, and elevated methylmalonic acid. What is the most appropriate treatment?

Accepted Answer

Intramuscular vitamin B12 replacement

Answer

Oral folic acid alone

Answer

Oral iron supplementation only

Answer

No treatment is needed

Answer

High-dose vitamin C

Practice question

A 72-year-old vegan woman presents with progressive paraesthesia and gait instability. Labs show haemoglobin 100 g/L, MCV 108 fL, low vitamin B12 level, and elevated methylmalonic acid. What is the most appropriate treatment?