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GI > Pernicious anaemia > Flashcards

Pernicious anaemia Flashcards

1
Q

what type of disease in pernicious anaemia?

A

autoimmune disorder

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2
Q

which vitamin is affected pernicious anaemia?

what happens to this vitamin’s levels?

A

vitamin B12

low

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3
Q

Define pernicious?

A

causing harm in a subtle or gradual way

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4
Q

why is diagnosis oft delayed?

A

because symptoms are subtle

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5
Q

Normal take up of Vit B12?

step by step

A
  1. Stomach’s parietal cells makes intrinsic factor
  2. Intrinsic factor binds to vit B12
  3. Vitamin B12-intrisnic factor is absorbed at the terminal ileum via a Ca2+ dependent process
  4. Enterocytes will bind vit B12 to transcobalamin II (a transport protein)
  5. Now B12 can move through blood.
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6
Q

where is intrinsic factor made?

A

Stomach

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7
Q

function of intrinsic factor?

A

bind to vit B12

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8
Q

which cells make intrinsic factor?

where are these cells located?

A

parietal cells

stomach

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9
Q

B12 is absorbed where?

which mineral is involved in the absorption here?

A

terminal ileum

Ca2+ (helps absorb vit B12)

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10
Q

vit B12 is bound to which transport protein so it can be carried in the blood?

where does this binding happen?

A

transcobalamin II

ileum

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11
Q

vitamin B12’s normal functions?

-2

A

make blood cells

myelinate nerves

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12
Q

in Pernicious anaemia, why does vit B12 absorption decrease?

-2 ways

A

o Intrinsic factor antibodies bind to intrinsic factor - this blocks vit B12’s binding site
o gastric parietal cell antibodies cause atrophic gastritis – thus intrinsic factor not made – less B12 absorbed

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13
Q

↓Vit B12 will cause what disorders generally speaking?

-2

A

macrocytic anaemia & neuropathy

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14
Q

which gender is a risk factor?

A

Females

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15
Q

which blood group is a risk factor?

A

Blood Group A

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16
Q

Risk Factors?

-4

A

Females
Middle to old age
Other autoimmune disorders
Blood Group A

17
Q

which cancer is a potential complication in pernicious anaemia?

A

Gastric Cancer

18
Q

Anaemia symptoms in pernicious anaemia?

A

Lethargy
Pallor
Dyspnoea

19
Q

neuro symptoms in pernicious anaemia can be split into what 3 categories?

A

Peripheral neuropathy features
Spinal cord degeneration
Neuropsychiatric features

20
Q

vit B12 deficiency signs at the mouth

-2

A

Glossitis – red tongue

central cyanosis

21
Q

skin colour in pernicious anaemia?

why does this happen?

A

lemon tinge

pallor from anaemia + mild jaundice

22
Q

Neuropsychiatric symptoms?

-5

A 
Memory loss 
Poor focus 
Confusion 
Depression 
Irritability
23
Q

Spinal cord degeneration symptoms?

-4

A

Progressive weakness
Ataxia
Spasticity
Paraplegia

24
Q

Peripheral neuropathy symptoms?
-3

which limbs are affected more?

A

Pins & needles
Numbness
Paraesthesia

legs more than arms

25
Q

define paraplegia?

A

paralysis of the legs

26
Q

define hemiplegia?

A

paralysis of one side of the body

27
Q

define ataxia?

A

inability to coordinate voluntary muscular movement due to a CNS disorder

28
Q

main Ix?
-4

results for each.

A

FBC: macrocytic anaemia, low WBC, low platelets
↓Vit B12
↓intrinsic factor
Antibodies: anti intrinsic factor antibodies & anti gastric parietal cell antibodies present

29
Q

what happens to platelets and WBC?

give the medical name

A

leukopenia

thrombocytopenia

30
Q

what happens to MCV?

A

high

31
Q

what does MCV stand for?

A

mean corpuscular volume

32
Q

1st line Mx?
-route

how much do you give?

A

Vitamin B12 IM injection

6 injections over 2 weeks, then 3 injections a month

33
Q

how do you change Mx if there are neuro symptoms?

A

Give more B12 if neuro symptoms present

34
Q

some pts will require what other supplement?

A

folic acid supplement

GI (25 decks)

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