NABP Exam NAPLEX Topic 3 Question 80 Discussion

Actual exam question for NABP's NAPLEX exam

Question #: 80
Topic #: 3

A 67-year-old female presents to your clinic complaining of fatigue, diarrhea, headaches and a loss of appetite. Upon examination you find that she is having some cognitive difficulty. Laboratory results reveal: MCV: 109fL; Hgb: 9g/dL; MMA and homocystine are both elevated. Shilling test is positive.

What is the next best step in the management of this patient?

ALifelong folic acid supplementation

BLifelong Vitamin B12 supplementation

CIron supplementation for 4-6 months

DObtain a Coomb's test

EGive corticosteroids and iron supplementation

Show Suggested Answer

Suggested Answer: C

A fasting blood glucose level of greater than 7 mmol/L (or greater than 126mg/dL) is an indicator of type 2 diabetes.

by Odette at Apr 27, 2024, 05:21 PM

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Loreta

1 months ago

Folic acid? Really? That's like trying to put out a fire with gasoline. This is a classic B12 deficiency, no question about it. Time to get that lady some serious B12 action!

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Dyan

1 months ago

The poor lady's got some serious cognitive issues. Maybe we should try to fix that first before worrying about the diarrhea and headaches, eh? B12 all the way, my friends.

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Terina

23 days ago

I think we should start with B12 supplementation to address the cognitive issues.

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Carmelina

2 months ago

Haha, corticosteroids and iron? What is this, a twofer special? Definitely not the right answer. B12 is the way to go, no doubt about it.

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Kayleigh

21 days ago

I've seen cases like this before, B12 is the way to go for sure.

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Annette

1 months ago

Yeah, B12 deficiency can cause all those symptoms. Lifelong supplementation is key.

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Shannan

1 months ago

I agree, B12 supplementation is definitely the next best step.

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Makeda

2 months ago

I'm not sure about the Coomb's test here. Isn't that for hemolytic anemia? This seems more like a malabsorption issue. I'd go with the B12 supplementation.

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Stephaine

2 months ago

This is clearly a case of pernicious anemia. The elevated MMA and homocystine, along with the positive Shilling test, point to a vitamin B12 deficiency. Lifelong B12 supplementation is the way to go.

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