Martin is a 42-year-old male. He presented to his physician with complaints of mild memory loss. During
Question:
Martin is a 42-year-old male. He presented to his physician with complaints of mild memory loss. During his visit, Martin mentioned that he exercises at least 4 days a week and maintains a strict vegetarian diet.
Martin is seen by his physician who suspects a deficiency in his diet may be contributing to his neurological symptoms. His physician decides to order vitamin testing for more information.
the result of Martin’s serum vitamin B12 laboratory test was 190 ng/L (Reference range 180–914 ng/L).
Although the result falls within the reference range, Martin’s physician doesn’t feel confident that he can rule out a deficiency.
The result of a serum methylmalonic acid (MMA) were 0.52 nmol/mL (reference range ≤ 0.40 nmol/mL). Given the moderately elevated MMA levels, Martin’s physician feels confident diagnosing him with vitamin B12 deficiency.
What vitamin deficiency do you suspect in this patient? Why?
What are common methods for the determination of vitamin B12?
What is another (potentially more definitive) test that may be ordered?
Why are these results more definitive than the vitamin B12 results?
Managerial Accounting
ISBN: 978-1259024900
9th canadian edition
Authors: Ray Garrison, Theresa Libby, Alan Webb