Female, aged 46 years, gastrectomy for duodenal ulcer 18 months prior to admission. Presented with anemia, weight loss and complaining that her stools were frequent, yellowish, and bulky.

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  1. Female, aged 46 years, gastrectomy for duodenal ulcer 18 months prior to admission. Presented with anemia, weight loss and complaining that her stools were frequent, yellowish, and bulky.
  2. Laboratory Tests
    Chemistry:
Calcium2.02(2.1-2.62 mmol/L)
Phosphate0.71(0.8-1.45 mmol/L)
Albumin40(35-55 g/L)
Alkaline phosphatase450(30-450 U/L)
Fecal fat70(<21g/3 days)

Hematology:

Hemoglobin120144-166 g/L
Smearmacrocytic red
cells
Prothrombin time28 s12 s
  1. Does this patient have malabsorption? Explain.
  2. Explain the likely cause for the decreased calcium and phosphate.
  3. Doe this patient have anemia? Explain.
  4. Explain the PT result.
  5. What deficiency can explain the Smear?
 
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