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16) A 49-year-old woman presents to the office because of complaints of fatigue. She has had
progressive exercise intolerance over the prior 6 months. On physical examination, she is pale
and afebrile. Her blood pressure is 112/68 mm Hg, and her pulse is 88/min. Heart and lung
examinations are normal except for a I/VI systolic flow murmur at the left sternal border.
Routine laboratory results reveal hemoglobin of 8.3 g/dL, a mean corpuscular volume of 118
μL/m3, and a B12 of 82 pg/mL (normal >210 pg/mL). She undergoes a Schilling test, which
reveals malabsorption of radiolabeled B12. Intrinsic factor is administered and the radiolabeled
B12 is subsequently absorbed. Which of the following is the diagnosis?
A. Atrophic gastritis
B. Bacterial overgrowth
C. Chronic pancreatitis
D. Crohn disease
E. Gastric ulcer

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so what do you think the answer is?

anas309
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