Question

A 50-year-old woman presents with a 3-month history of fatigue, generalised aches, and low mood. Blood tests reveal: Haemoglobin 105 g/L (Ref: 115-165), MCV 108 fL (Ref: 80-100), Serum B12 <150 ng/L (Ref: 197-771), Serum Folate normal. What is the most appropriate initial treatment?

Accepted Answer

Hydroxocobalamin 1mg intramuscularly, 3 times a week for 2 weeks

Answer

Oral cyanocobalamin 1mg daily

Answer

Hydroxocobalamin 1mg intramuscularly, once daily for 1 week

Answer

Oral folic acid 5mg daily

Answer

Blood transfusion

Practice question

A 50-year-old woman presents with a 3-month history of fatigue, generalised aches, and low mood. Blood tests reveal: Haemoglobin 105 g/L (Ref: 115-165), MCV 108 fL (Ref: 80-100), Serum B12 <150 ng/L (Ref: 197-771), Serum Folate normal. What is the most appropriate initial treatment?