A 69 year patient is referred to the PCP for follow: Weight loss, difficulty swallowing, and abnormal tongue swelling non-allergic

PMHx: ESRD w/dialysis, Anemia, hypertension, and tobacco used 30 years 1 pack a day.

Shared labs:
Hgb: 11.3
MVC 82.0L
MCH 23.7 L
RDW 18.5H
Ferritin 1498
B12: > 2000
folate 5.3
WBC normal
BMP: normal
HDL 60
LDL 100
AST < 9
ALT < 9

1. What labs or procedures are you running to confirm your diagnosis?

2. What is your diagnosis?

3. What are your recommendations for the patient?

4. What areas of your comprehensive exam should be included?


5. What are some of the causes of elevated B12 levels?

6. Which is the highest risk factors for oral cancer worldwide and in the United States?


7. The USPSTF recommends oral screening in asymptomatic patients?


8. An Oral abnormality present longer than ______ should be reevaluated and considered for a biopsy.


9. What initial confirmation of oral CA or G.I. CA might you expect the referring physician to complete or than labs?


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