PERNICIOUS ANEMIA - megaloblastic, chronic anemia due to deficiency of intrinsic factor leading to Hypochlorhydria ± decrease Hcl acid secretion

. Lifetime B12 injections. With CNS involvement. Predisposing factor 1. Subtotal gastrectomy ± removal stomach 2. Hereditary 3. Infl dse of ileum 4. Autoimmune 5. Strict vegetable diet STOMACH Parietal or ergentaffen Oxyntic cells Fxn ± produce intrinsic factor For reabsorption of B12 For maturation of RBC Diet high caloric or CHO to correct wt loss S/Sx: 1. 2. Fxn ± secrets Hcl acid Fx aids in digestion

Headache dizziness, dyspnea, palpitations, cold sensitivity, gen body malaise, pallor GIT changes a. Red ± beefy tongue ± PATHOGNOMONIC ± mouth sores b. Dyspepsia ± indigestion c. Wt loss d. Jaundice 3. CNS ± Most dangerous anemia: pernicious due to neuroglogic involvement. a. Tingling sensation b. Paresthesia c. (+) Romberg¶s test Ataxia d. Psychosis Dx:- Shilling¶s test Nsg Mgt ± Pernicious anemia 1. Enforce CBR 2. Administer B12 injections at monthly intervals for lifetime as ordered. IM- dorsogluteal or ventrogluteal. Not given oral ± due pt might have tolerance to drug 3. Diet ± high calorie or CHO. Increase CHON, iron & Vit C 4. Avoid irritating mouthwashes. Use of soft bristled toothbrush is encouraged. 5. Avoid applying electric heating pads ± can lead to burns