Which of the following is normal in patients with pernicious ...

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Which of the following is normal in patients with pernicious anemia (PA)?
 
  a. Trypsin levels
  b. Intrinsic factor (IF)
  c. Stomach acid
  d. Absorption of vitamin B12

Question 2

Which of the following is the best source of dietary vitamin B12?
 
  a. Fruit
  b. Green vegetables
  c. Meat
  d. Legumes

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Answer to Question 1

ANS: A
Trypsin is normal in patients with PA. The root cause of PA is a deficiency of IF because of autoimmune attack, either of IF itself or of the parietal cells in which it is synthesized. Atrophic gastritis develops; this affects the secretion of H+, which affects gastric (stomach) acidity, important for normal digestive processes.

Answer to Question 2

ANS: C
Meat provides the best source of vitamin B12; meat byproducts such as milk and eggs are sources other than meat. Plants have no need for this vitamin, and so it is not available in green vegetables, legumes, or fruit. Thus it is possible, over time, for a true dietary deficiency to develop for a strict vegetarian (i.e., vegan).

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