4. Megaloblastic anemia: etiology, pathogenesis, clinical manifestation, diagnosis, treatment.

Question 1

what is the typical peripheral the peripheral blood smear for macrocytic anemia

Answer 1

oval macrocytes

reduced or absent central pallor

hypersegmnetd neutrophils

Question 2

what are the clinical lab values ?

Answer 2

MCV = higher than100
high indirect bilirubin = due to erythropoiesis andhemolysis

very high LDH

low reticulocyte count

Question 3

what is seen in bone marrow biopsy

Answer 3

hyperplastic - erythrocyte precursors predominating
nuclear to cytoplasm asynchrony

orthochromatic megaloblast = cytoplasm appears mature but the nucleus is immature

giant metamyelocytes with enlarged nucleus

Question 4

what are the neurological manifestation in megaloblastic anemia ?
only in vit b12 deficicny

Answer 4

defects in myelin sheaths

parenthesis of finiger and toes

reduced vibration sense and proprioceptor

ataxia

dementia , memory loss

depression

megaloblastic madness = paranoid schizophrenia

presverse to smell and taste

Question 5

causes of megaloblastic anemia ?

Answer 5

gastric resection = deficiency of intrinsic factor
autoimmune gastitus

low dietary intake

Question 6

what are the general signs and symptoms ?

Answer 6

hemolysisi with icterus = ineffective abc production

atrophic glossitis = smooth red tongue

Question 7

what is the treatment of megaloblastic anemia ?

Answer 7

parenteral treatment with vib12 = need to see an increasing reticulocyte count

Question 8

what is the difference between folic acid deficiency and megaloblastic ?

Answer 8

no neurological symptoms
but can lead to spina bifida in neonate
excessive alcohol

Question 9

what is the aetiology of folic acid deficiency ?

Answer 9

malnuttuion
malabsorption
alcohol