Macrocytic Anemia
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show | MCV>100 femtoliters (fL)
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What is the bioche mical significance of megablastic anemia? | show 🗑
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What are the morphologic findings in blood and marrow tissue in megaloblastic anemia? | show 🗑
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Describe the mechanism of megaloblasic anemia due to folate deficiency. | show 🗑
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show | Vitamin B12 is indirectly required for the conversion of folate to a form required for the synthesis of thymidylate.
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show | In the stomach, vit B12 dissociated from food and binds to R protein. In the duodenum, B12 is released from R protein and binds to intrinsic factor (IF). The B12-IF complex binds to membrane receptors in the ileum.
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What cells produce intrinsic factor (IF)? | show 🗑
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show | Vitamin B12 is transported in the plasma by binding to transcobalamin II (TCII)
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show | (1) Liver (2) Macrophages (3) Endothelial cells
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What biochemical processes is cobalamin essential for? | show 🗑
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show | Certain bacteria and animal muscle/organs
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show | Intrinsic factor deficiency
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show | Pernicious anemia, Gastrectomy, Destruction of gastric mucosa, Anti-IF antibody in gastric juice
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show | False. A poor diet is a very rare cause of Vitamin B12 deficiency anemia.
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show | Ileum
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An autoimmune disease in which parietal cell antibodies against gastric H+/K+ ATPase result in the destruction of gastric parietal cells, resulting in achlorhydria and decreased or absent intrinsic factor secretion. | show 🗑
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show | Methylmalonic acid and homocysteine are elevated.
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What chemical blocks hepatic release of folate into bile? | show 🗑
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What form is folate present in food? | show 🗑
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What is the methylfolate trap hypothesis? | show 🗑
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show | Explains how B12 deficiency results in folate deficiency, based on the concept that only formylated folate can be conjugated. Lack of methionine decreases formate levels, resulting in impaired formylation of FH4, thus no conjugation to N5,10-methylene FH4
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show | Green leafy vegetables, fruit, dairy products, yeast and animal livers.
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show | Poor diet (ex: alcoholism, infancy, dialysis)
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show | Jejunum
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What is the daily requirement of cobalamins? | show 🗑
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What is the daily requirement of folate? | show 🗑
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show | The body stores a small amount that lasts for a few months.
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show | The body stores a large amount that lasts for years.
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What is a major complication of vitamin B12 deficiency? | show 🗑
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Will folate administration correct the neurologic deficits resulting from vitamin B12 deficiency? | show 🗑
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show | Myeloma, pregnancy, and technetium/gallium scans.
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show | Prenicious anemia
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