J.K. is a 26-year-old male who presented

J.K. is a 26-year-old male who presented with pallor and fatigue. He complains of a two-day history of difficulty expressing his thoughts and problems with both concentration and short-term memory. In addition, he describes a three-month history of bilateral lower extremity numbness and weakness that has been progressing upwards and gait difficulty. Onset of his symptoms was gradual and included numbness and intermittent tingling sensations in both hands and both feet. He described his gait difficulty as “unsteadiness that is worse in the dark.” He also reported an episodic shooting pain that begins in his neck and passes down his back and into both arms. He denied any history of previous trauma. Clinical symptoms are subjective expressions of disease that can only be reported by the patient. Identify a minimum of eight symptoms in the case study above that are consistent with a diagnosis of vitamin B12 deficiency/anemias in general. Laboratory Blood Test Results B.With reference to the laboratory blood test results above, identify a minimum of two laboratory blood test findings that are consistent with a diagnosis of vitamin B12 deficiency. The patient is also exhibiting the following test results from a peripheral blood smear and serum antibody test: Peripheral Blood Smear • Anisocytosis • Poikilocytosis • Giant platelets • Hypersegmented neutrophils, some with 6 lobes • Macrocytic RBC Serum Antibodies • (-) IF • (-) parietal cells C. Based on these findings, does this patient have pernicious anemia? Briefly explain your answer. D. Define the peripheral blood smear results in terms of the morphological appearance of the cells described.

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