You have an adventurous 21 y.o. m patient who just came back from a trip to Africa where he states he ate all the local foods even though some looked raw still. He says that despite this, he ate well while he was there and had adequate food intake in the week since he has been back, but despite this he has lost 15 pounds. He is also worried about his other symptoms of fatigue, paresthesias and inability to �think straight� in college. Upon exam you note a smooth tongue and decreased vibratory sense on his toes, with normal exam on his hands and ankles. You suspect what anemia secondary to what other disease process? What is the treatment?
TAPEWORM EWWWWW it is impairing his absorbtion of B12 causing pernicious anemia, Kill the tapeworm, and cobalamin 1,000 mg IM