For pernicious anemia, ongoing management should include which long-term plan?

• A. Lifelong vitamin B-12 injections
• B. Short-term therapy only
• C. Oral supplementation only
• D. No treatment after stabilization

Answer: (A)

The ongoing plan hinges on replacing vitamin B12 indefinitely because pernicious anemia is caused by a deficiency of intrinsic factor, which is needed to absorb B12 from the gut. Without intrinsic factor, oral B12 absorption is unreliable, so the most reliable way to maintain normal B12 levels and prevent relapse is to deliver B12 directly into the bloodstream through lifelong injections. This long-term approach prevents recurrent anemia and protects against potential neurologic damage that can occur with ongoing B12 deficiency. Short-term therapy would not prevent relapse, and relying on oral supplementation alone is not consistently effective for this condition. Stopping treatment after stabilization would allow the anemia and symptoms to reappear.