Question

A 62-year-old vegan man presents with paraesthesia in his feet and unsteadiness. Examination shows impaired vibration sense and positive Romberg’s sign. Blood tests show macrocytosis and low serum vitamin B12. What is the most appropriate treatment?

Accepted Answer

Intramuscular hydroxocobalamin injections

Answer

Oral folic acid alone

Answer

High-dose oral vitamin C

Answer

No treatment required

Answer

Red cell transfusion only

Practice question

A 62-year-old vegan man presents with paraesthesia in his feet and unsteadiness. Examination shows impaired vibration sense and positive Romberg’s sign. Blood tests show macrocytosis and low serum vitamin B12. What is the most appropriate treatment?