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Macrocytic anemia.
| Question | Answer |
|---|---|
| What is Megaloblastic anemia? | Anemia with MCV > 100 micro cubic meters ; most commonly due to folate or vitamin Bl2 deficiency (megaloblastic anemia) |
| What happens in Megaloblastic anemia? | One less division. because of low DNA precursors. |
| What are the causes of Megaloblastic anemia? | Folate def and Vit B12 are necessary for DNA precursor molecules. |
| how does Follate and B12 play in RBC production? | THF--> is methylated in body. If need to be activated, it need to demethylate. Thus Vit B12 takes the methly group. Vit B12 passes it on to Homocystine - Methaoinine. |
| If follate or B12 is knocked out what happens? | No DNA, Megaloblastic anemia, Hypersegmented neutrophils- Megaloblastic change in epithelial cells |
| If normal Folate and Vit B12 and till MCV>100 micro cubic meters | This situation is then called Macrocytic anemia and is due to alcoholism , Liver disease and drugs BUT NO!!! Hypersegmented neutrophils- Megaloblastic change in epithelial cells |
| Difference between Megaloblastic and macrocytic anemia? | Macrocytic anemia-NO!!! Hypersegmented neutrophils- Megaloblastic change in epithelial cells |
| Follate defciency ? | vegis and fruit absorbed in jejunum. Stores are small. poor diet (e.g., alcoholics and elderly), increased demand (e.g., pregnancy, cancer, and hemolytic anemia), and folate antagonists (e.g., methotrexate, which inhibits dihydrofolate reductase). |
| Laboratory findings of Follate defciency ? | l. Macrocytic RBCs and hypersegmented neutrophils (> 5 lobes, 2. Glossitis 3. low serum folate 4. high serum homocysteine (increases risk for thrombosis) 5. Normal methyl malonic acid as B12 is normal to convert to ScoA |
| Vit B12 absorbtion? | eggs and protiens have B12. B12 is cleaved and attached to R binder. this travels to Small interesting. Proteases by pancrease cleave the R binder. Vit B12 bind to intrinsic factor by parietal cells of tummy. Then in illuem it is absorbed. Stores= large |
| if stores are large then Most common cause of B12 def? | Pernecious anemia- autoimmune destruction of the parietal cells of the tummy- low intrinsic factor. |
| other causes of Vit B12 def? | Other causes of vitamin Bl2 deficiency include pancreatic insufficiency and damage to the terminal ileum (e.g., Crohn disease or Diphyllobothrium latum [fish tapeworm]); dietary deficiency is rare, except in vegans. |
| Clinical and laboratory findings of the Vit B12 def | 1. Macrocytic RBCs with hypersegmented neutrophils 2. Glossitis 3. Subacute combined degeneration of the spinal cord 5. high serum homocysteine 6. high methylmalonic acid (unlike folate deficiency) |
| why is there Subacute combined degeneration of the spinal cord with Vit B12 def? | Vitamin Bl2 deficiency results in increased levels of methyl malonic acid, which impairs spinal cord myelinization. iii. Damage results in poor proprioception and vibratory sensation (posterior column) and spastic paresis (lateral corticospinal tract) |
Created by:
atayal
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