During your Internal Medicine rotation, you are evaluating a…
During your Internal Medicine rotation, you are evaluating a 38-year-old patient noted to have macrocytic anemia with an MCV 124 on a recent CBC. When reviewing the patient’s chart, you verify that her CBC was normal during her most recent prior physical three years ago. On further questioning, the patient tells you that she had been following a strict vegetarian diet for the past several years. The patient tells you that she has recently started to have difficulty sensing where the floor is, when she gets up during the night in the dark to use the bathroom. She now has to turn on a light to “see where my feet are on the floor” (impaired position sense). Based on this information, which of the following conditions is the most likely diagnosis for this patient?