Macrocytic Anaemias (haematology) Flashcards

1
Q

What are the causes of macrocytosis except for vit b12 and folate deficiency? (6)

A

-Alcohol, smoking, liver disease, myeloma, drugs, reticulocytosis, aplastic anaemia.

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2
Q

Vit B12 and folate are essential for the synthesis of:

A

-DNA

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3
Q

Another name for vitamin B12

A

Cobalamin

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4
Q

Which protein transports cobalamin?

A

Transcobalamin

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5
Q

Causes of cobalamin deficiency (2)

A

Nutritional (vegans)
Malabsorption, can be due to gastric (pernicious anaemia) or intestinal causes.

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6
Q

How does pernicious anaemia cause vit b12 deficiency?

A

-It causes autoimmune gastritis, which leads to gastric atrophy, this causes reduced levels of acid and IF (binds with vit b12 to be absorbed) but elevated levels of gastrin.

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7
Q

What are the causes of folate deficiency?

A

-Nutritional
-Malabsorption
-Increased folate utilisation
-Increased loss or folate through urine
-Drugs
-Mixed

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8
Q

Pathogenesis of folate deficiency (4)

A

-Impaired DNA synthesis.
-Ineffective erythropoiesis, granulopoiesis and theombopoiesis.
-Exaggerated apoptosis of late precursors
-Haemolysis which reduced the red cell life span by 30-50%

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9
Q

What are the clinical features of folate deficiency (4)

A

-Glossitis
-Purpura
-Risk for neural tube defects and cardiovascular diseases.
-Reversible melanin pigmentation.

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10
Q

What are the laboratory features of folate deficiency? (5)

A

-Hypersegmented neutrophils.
-Low reticulocyte count.
-Leukocyte and platelets count may be reduced.
-Hypercellular bone marrow.
-Raised unconjugated bilirubin.

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11
Q

What is important to note with regards to the treatment of vit b12 and folate deficiency?

A

Do not give folic acid alone unless if vitamin b12 is excluded in the diagnosis because it can aggravate neuropathy.

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12
Q

Treatment for:
1. Vit B12 deficiency
2. Folate deficiency

A
  1. Hydroxocobalamin
  2. Folic acid
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13
Q

A
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