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22nd May 2023
A 75-year-old lady attends the GP with her daughter
A 75-year-old lady attends the GP with her daughter, who has concerns that her mother has slowly become more confused over the past couple of months. Her daughter is worried this might be dementia.
The GP sends off some confusion screen blood tests. These come back showing:
| Hb | 92 g/L | Female (115-160 g/L) |
| WBC | 8.0 x 10⁹/L | (4.0-11.0 x 10⁹/L) |
| Platelets | 190 x 10⁹/L | (150-500 x 10⁹/L) |
| MCV | 118fL | (82-100fL) |
| Corrected Calcium | 2.54 mmol/L | (2.1-2.6 mmol/L) |
| Vitamin B12 | 103 ng/L | (200-900 ng/L) |
| Folate | 2.0 nmol/L | (>3.0 nmol/L) |
| TSH | 2.4 mu/L | (0.5-5.5 mu/L) |
| Intrinsic factor antibodies | Negative |
Which one of the following options would be the most appropriate management in this case?
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