Thyroid & Adrenal
An alcoholic and chronic smoker presents with a swollen tongue and atrophy of papillae in the tongue with—Hb 1l.5g%, PCV 35%, MCV 100. What is the appropriate line of management?
|A||Surgical biopsy of tongue|
|B||Evaluate thiamine levels|
|C||Give Folic Acid|
a. In folate deficiency, a patient presents with a history of excessive alcohol intake with concurrent poor diet intake.
b. Patients may be pregnant or lactating; may take certain drugs, such as phenytoin, sulfonamides, or methotrexate; may have chronic hemolytic anemia; or may have underlying malabsorption.
c. Some patients complain of a sore tongue or pain upon swallowing. Angular stomatitis also may be observed. These oral lesions typically occur at the time when folate depletion is severe enough to cause megaloblastic anemia, although, occasionally, lesions may occur before the anemia.
d. Patients may present with GI symptoms, such as nausea, vomiting, abdominal pain, and diarrhea, especially after meals. Anorexia also is common and, in combination with the above symptoms, may lead to marked weight loss.
e. Patients whose folic acid deficiency is related to dietary factors should be counseled to include green vegetables and fruit in their diet.