Family Nurse Practitioner Exam

A patient who had a gastrectomy is at higher risk for which type of anemia?

1. Folate deficiency anemia

2. B12-deficiency anemia

3. Iron-deficiency anemia

4. Normocytic anemia

The correct answer is: B12-deficiency anemia

A patient who has undergone a gastrectomy is at a higher risk for B12-deficiency anemia due to several physiological changes that occur following the removal of part or all of the stomach. The stomach plays a critical role in the absorption of vitamin B12, primarily by producing intrinsic factor, a protein that is essential for the absorption of this vitamin in the small intestine. After gastrectomy, the reduced production of intrinsic factor can lead to impaired absorption of vitamin B12, which is crucial for red blood cell production and neurological function. As a result, a deficiency in this vitamin can lead to megaloblastic anemia characterized by the presence of large, immature red blood cells in the bloodstream. Other anemia types, like folate deficiency anemia, iron-deficiency anemia, and normocytic anemia, do not have the same direct connection to the physiological changes following stomach removal. This makes B12-deficiency anemia particularly significant in the context of a patient with a history of gastrectomy. Recognizing this risk is essential for follow-up and management in these patients, including potential supplementation of vitamin B12 to prevent anemia and associated complications.