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Old 08-27-2015
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A chronic alcohol abuser goes to the ER with weakness, a sore, beefy red tongue, loss of vibration and position sense, arm and leg dystaxia, elevated levels of methylmalonic acid in the urine, and anemia with an MCV above 105 fL. What is your diagnosis, and how will you monitor his response to treatment?

Subacute combined degeneration of the spinal cord is
treated with IM vitamin B12 injections. If treatment is
working, you will see an increased reticulocyte count
on the peripheral smear in about 5 days.

see more cases on
Dyci, SmashUSMLE Reviews Representative

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