Question

Need with this strange article question:

A 44-year-old woman who recently lost her job because of absenteeism presents to her physician complaining of loss of appetite, fatigue, muscle weakness, and emotional depression. The physical examination reveals a somewhat enlarged liver that feels firm and nodular, and there is a hint of jaundice in the sclerae and a hint of alcohol on her breath. The initial laboratory profile included a hematologic analysis that showed that she had an anemia with enlarged red blood cells (macrocytic). A bone marrow aspirate confirmed the suspicion that she has a megaloblastic anemia because it showed a greater than normal number of red and white blood cell precursors, most of which were larger than normal. Further analyses revealed that her serum folic acid level was 2.9 ng/mL (normal = 6 to 15), her serum B12 level was 153 pg/mL (normal= 150 to 750), and her serum iron level was normal. Megaloblastic anemia in this patient is most likely caused by which of the following?

A. Decreased synthesis of methionine

B. Decreased conversion of d-UMP to d-TMP

C. Decrease in the synthesis of phosphatidyl choline

D. Decrease in the levels of succinyl Co-A

E.. Decreased synthesis of d-UTP

Answer 1

The correct answer is ( a) as methionine is required for vitamin B12 metabolism. Deficiency of vitamin B12 is reason of megaloblastic is low level of B 9 and B 12.