A 65-year-old experienced loss of appetite, weight loss, lemon-yellow skin, liver enlargement, and a beefy red tongue shortly before her death. Autopsy suggested pernicious anemia, and the cause of death would most likely reveal:
a. brain hypoxia.
b. liver hypoxia.
c. heart failure.
d. kidney failure.
ANS: C
When the hemoglobin has decreased to 7-8 grams per deciliter, the individual experiences the classic symptoms of anemia: weakness, fatigue, paresthesias of feet and fingers, difficulty walk-ing, loss of appetite, abdominal pain, weight loss, and a sore tongue that is smooth and beefy red. The skin may become lemon yellow (sallow), which is caused by a combination of pallor and jaundice. Hepatomegaly, indicating right-sided heart failure, may be present in the elderly. The symptoms are not associated with brain or liver hypoxia, or kidney failure.
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