Question

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:

Calcium	2.02	(2.1-2.62 mmol/L)
Phosphate	0.71	(0.8-1.45 mmol/L)
Albumin	40	(35-55 g/L)
Alkaline phosphatase	450	(30-450 U/L)
Fecal fat	70	(<21g/3 days)

Hematology:

Hemoglobin	120	144-166 g/L
Smear	macrocytic red cells
Prothrombin time	28 s	12 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?

Answer 1

1. Yes ,the patient has malabsorption because the sign and symptoms depicted above resembles intestinal malabsorption . Malabsorption is a condition in which the nutrients from the food are absorbed by the intestine to the bloodstream .

2. The likely cause for the decreased calcium and phosphate is malabsorption .

3. Yes ,the patient have anemia ,her hemoglobin levels are below the normal range . In malabsorption there is bleeding as one of the sign and symptoms it might be the reason behind her less hemoglobin levels.

4. The PT result is above the normal range which means she has risk of bleding and it takes more time for her to form a clot .