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ModerateHaematologyVitamin B12 deficiencyuk-plab-1

A 70-year-old vegan man presents with progressive numbness in his feet, gait disturbance and a sore tongue. Examination shows loss of vibration sense in both legs and a positive Romberg sign. Blood tests reveal macrocytosis, low haemoglobin and low vitamin B12. What is the most appropriate initial treatment?

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