17. Florence is a 72 y.o. female who presents to your office for a “check-up”
after getting out of rehab 2 weeks ago.
Her daughter is with her and states
that her Mom is living with her at this time and she hasn’t had a drink in
about 6 weeks.
Florence states that she still has episodes of nausea, but
her blood sugars are better – staying between 100-225 since getting out of
rehab and that her appetite is better now, but her mouth is sore. Florence
has been an alcoholic for at least 30 years and 6 months ago she was
drinking a 5
of Vodka a day and sometimes more.
Her daughter is worried
because she seems to be falling more in the past week or so and Florence
keeps telling her that she’s catching her slippers on the carpet.
exam, you note the following:
watching Florence walk in the hall she seems
to “go to the left” – grabbing for the wall so she doesn’t fall.
She has a
positive Romberg’s test, and pulls her feet away when you try to examine
What is your differential diagnosis for Florence? List 3 -
Explain why individuals with pernicious anemia have a low
hemoglobin level? _______________________________________