Gastrointestinal System Disorders Q 146 - Gyan Darpan : Learning Portal
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Thursday, 14 April 2022

Gastrointestinal System Disorders Q 146

The nurse is caring for a client with chronic gastritis. The nurse monitors the client, knowing that this client is at risk for which of the following vitamin deficiencies?
    A. Vitamin A
    B. Vitamin B12
    C. Vitamin C
    D. Vitamin E

Correct Answer: B. Vitamin B12

Chronic gastritis causes deterioration and atrophy of the lining of the stomach, leading to the loss of the functioning parietal cells. The source of the intrinsic factor is lost, which results in the inability to absorb vitamin B12. This leads to the development of pernicious anemia. Acute gastritis will evolve to chronic, if not treated. Helicobacter pylori (H. pylori) is the most common cause of gastritis worldwide. However, 60 to 70% of H. pylori-negative subjects with functional dyspepsia or non-erosive gastroesophageal reflux were also found to have gastritis.

Option A: Pernicious anemia can develop in AMAG with an overall prevalence of 0.1%. It can present with fatigue, dizziness, irritability, depression, insomnia, and mood swings. Occasionally, it can present with normal vitamin B12 levels. Most individuals are already treated for their iron, folate, or vitamin B12 deficiency without a confirmed underlying diagnosis.
Option C: Chronic atrophic gastritis is often diagnosed late, as many individuals can be asymptomatic for years and diagnosed incidentally. It is essential to investigate those with risk factors, such as the new onset of upper gastrointestinal symptoms in those over 50 years of age, pernicious anemia, or with a family history.
Option D: The incidental finding of anemia (iron deficiency or B12) should be investigated alongside medical treatment to avoid delay in diagnosis. The classical presentation would suggest individuals presenting with epigastric pain, nausea, and occasionally vomiting; however, this is rare. The most common presentation is anemia.

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