Are there any aspects of her physical exam that suggest a B12 deficiency?
Mucosal and skin pallor are subtle signs. 5) Given her history and physical exam findings, what laboratory test(s) would you order? In addition to the usual chemistry panel and complete blood count (CBC) with smear to check for anemia, a serum B12 test should be ordered. Low-normal levels indicate a need for further assessment because serum levels can be maintained at the expense of liver stores even in the presence of ongoing malabsorption.
