A nurse is caring for a patient with vitamin B12 deficiency anemia.
Which statement by the patient indicates a possible cause of their condition?
A “I have been following a strict vegan diet for the past year.”
B “I recently had a gastrectomy to treat my stomach ulcer.”
C “I take acid-suppressing drugs regularly for my heartburn.”
D “I have a family history of pernicious anemia.”
The correct answer and Explanation is :
The correct answer is: A “I have been following a strict vegan diet for the past year.”
Explanation:
Vitamin B12 deficiency anemia occurs when there is insufficient vitamin B12 in the body to produce healthy red blood cells. This vitamin is crucial for red blood cell production and neurological function.
- Strict Vegan Diet: Vitamin B12 is primarily found in animal products such as meat, dairy, and eggs. Therefore, individuals who follow a strict vegan diet are at higher risk for vitamin B12 deficiency because plant-based diets typically lack sufficient amounts of this vitamin unless fortified foods or supplements are consumed. A vegan diet without proper supplementation or fortified foods can lead to a deficiency over time.
- Gastrectomy: While a gastrectomy can affect vitamin B12 absorption, it typically involves a significant reduction in stomach size or removal of part of the stomach. This surgical procedure can affect intrinsic factor production, which is essential for vitamin B12 absorption. However, the most direct link to a vitamin B12 deficiency due to a gastrectomy is not as immediate as with dietary causes. This complication is more relevant in a longer-term context post-surgery.
- Acid-Suppressing Drugs: Acid-suppressing medications can impact vitamin B12 absorption because they reduce stomach acid, which is necessary for separating vitamin B12 from food proteins. However, this effect is often more subtle and gradual, and the direct link to anemia may not be as pronounced without a history of long-term use or other contributing factors.
- Family History of Pernicious Anemia: Pernicious anemia is an autoimmune condition that impairs vitamin B12 absorption due to a lack of intrinsic factor. A family history can increase the risk of developing this condition, but the statement about a family history does not directly indicate an immediate cause of vitamin B12 deficiency in the absence of symptoms or a diagnosis.
In summary, the most direct and immediate cause of vitamin B12 deficiency in this scenario is the strict vegan diet, which lacks adequate sources of vitamin B12 unless supplemented or fortified.