Which physical finding is suggestive of pernicious anemia?

The presence of loss of position and vibratory sensation is a suggestive physical finding in pernicious anemia due to the impairment of the nervous system associated with vitamin B12 deficiency, which is the underlying issue in this condition. Pernicious anemia is characterized by a lack of intrinsic factor, leading to decreased absorption of vitamin B12. Vitamin B12 is crucial for the proper functioning of the nervous system and the formation of red blood cells.

When there is a deficiency of vitamin B12, it can lead to damage of the myelin sheath – the protective covering of nerves – particularly in the dorsal columns of the spinal cord. This damage results in the loss of proprioception (position sense) and vibratory sensations. Patients may experience difficulties in coordination and may present with gait instability as a result. Recognizing these neurological signs is essential for identifying pernicious anemia and prompting further evaluation and treatment.

In contrast, other physical findings, such as splenomegaly and hepatomegaly, are more indicative of conditions related to hemolytic anemia or liver diseases, while petechiae and ecchymosis are signs of bleeding disorders or thrombocytopenia, not specifically related to vitamin B12 deficiency. Cheilosis and koilonychia are manifestations