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Deb Smith, age fifty-six, came to her nurse practitioner (NP) with fatigue, pallor, dyspnea on exertion, and palpitations. Her laboratory report indicates that her hematocrit, hemoglobin, and reticulocyte counts are low; that her MCV is high; and that her MCH and MCHC are normal. Her diagnosis is pernicious anemia.
Answer the following questions regarding Deb�s anemia and provide the pathophysiology associated with the body�s response to this disease process.
� Why should Deb’s NP ask her about paresthesia and ataxia?
� Why did her NP prescribe vitamin B12 by intramuscular injection rather than orally?
� What causes pernicious anemia?
� What are the technical terms that describe an anemia with high MCV and normal MCH?
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