Question

A 64-year-old vegan woman complains of numbness in her feet and unsteadiness. Examination shows reduced vibration sense in both legs and a positive Romberg’s test. Blood tests reveal macrocytic anaemia with low vitamin B12. What is the most appropriate initial treatment?

Accepted Answer

Intramuscular hydroxocobalamin injections

Answer

Oral folic acid alone

Answer

High-dose oral iron

Answer

No treatment, as she is vegan

Answer

Blood transfusion only

Practice question

A 64-year-old vegan woman complains of numbness in her feet and unsteadiness. Examination shows reduced vibration sense in both legs and a positive Romberg’s test. Blood tests reveal macrocytic anaemia with low vitamin B12. What is the most appropriate initial treatment?