Case study 7.docx

Mr. X, age 57, presented to his physician with marked fatigue, nausea with occasional diarrhea,and a sore, swollen tongue. Lately, he also has been experiencing a tingling feeling in his toesand a feeling of clumsiness. Microscopic examination of a blood sample indicated a reducednumber of erythrocytes, many of which are megaloblasts, and a reduced number of leukocytes,including many large, hypersegmented cells. Hemoglobin and serum levels of vitamin B12 werebelow normal. Additional tests confirm pernicious anemia. Relate the pathophysiology of pernicious anemia to the manifestations listed above. Discuss how the gastric abnormalities contribute to vitamin B12 and iron deficiency and how vitamin B12 deficiency causes complications associated with pernicious anemia. Discuss other tests that could be performed to diagnose this type of anemia. Discuss the treatment available and the limitations. Discuss the contributing factors to shock in this case and the pathophysiologic changes causing the changes in vital signs. Discuss the signs and symptoms of shock, including the rationale for each, as seen in the early stage, and as compensation mechanisms respond. Discuss emergency and follow-up treatment for shock and for complications that may arise if not treated quickly. Compare the types of shock, giving a specific cause, classification, and any significant changes in onset or manifestations. When a person goes