A patient with a gastrectomy history has an MCV of 115 fL. What is the most likely pathological mechanism?
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Correct answer: Intrinsic Factor deficiency leading to Vitamin B12 malabsorption
Gastrectomy removes parietal cells that produce Intrinsic Factor. This leads to Vitamin B12 deficiency (pernicious anemia), a classic megaloblastic macrocytic anemia characterized by a high MCV.
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