A patient has a decreased vitamin B12 assay. The Schilling test detects labeled vitamin B12 in the urine when it is given with IF. What is the correct interpretation?
a. Vitamin B12 assay probably incorrect
b. PA
c. Vitamin B12 deficiency that is not PA
d. Gastric analysis should be performed
ANS: B
The Schilling test is used to determine if the reason for low vitamin B12 is due to inability to absorb because of lack of IF or if the problem in absorption is related to something else. Because IF apparently corrected the problem in absorption, PA is the diagnosis. If some other malabsorption problem existed, then the addition of IF would not have corrected the problem and the labeled vitamin B12 would not have appeared in the urine.
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