45 Anemia Resulting from other Nutritional Deficiencies

Question 1

TRUE OR FALSE

Chronic deprivation of vitamin A results in anemia similar to that observed in iron deficiency.

Answer 1

TRUE

Chronic deprivation of vitamin A results in anemia similar to that observed in iron deficiency.

Question 2

Patients receiving therapy with this antituberculosis agents interfere with vitamin B6 metabolism, develop a microcytic anemia

Answer 2

Isoniazid

Question 3

TRUE OR FALSE

Pantothenic acid deficiency, when artificially induced in humans, is associated with anemia.

Answer 3

FALSE

Pantothenic acid deficiency, when artificially induced in humans, is not associated with anemia.

Question 4

Megaloblastic anemia, responsive to thiamine, occurs in a childhood syndrome in association with diabetes and sensorineural deafness

Answer 4

Rogers syndrome

Question 5

Mutation implicated in all cases of thiamine responsive megaloblastic anemia

Answer 5

SLC19A2 gene on chromosome 1q23.3

Question 6

This vitamin serves to facilitate intestinal iron absorption by maintaining iron in the more soluble reduced or ferrous (Fe2+) state

Answer 6

Vitamin C

Question 7

Deficiency of this vitamin in humans are limited to the neonatal period and to pathologic states associated with chronic fat malabsorption.

Answer 7

Vitamin E

Question 8

Vitamin E supplementation has been used in these conditions

Answer 8

Cystic fibrosis
Sickle cell anemia

Question 9

Present in a number of metalloproteins

Namely cytochrome c oxidase, dopamine β-hydroxylase, urate oxidase, tyrosine and lysyl oxidase, ascorbic acid oxidase, and superoxide dismutase (erythrocuprein)

Required for the absorption and utilization of iron

Answer 9

Copper

Question 10

More than 90% of the copper in the blood is carried bound to

Answer 10

Ceruloplasmin

Question 11

Form of copper that converts iron to the ferric (Fe3+) state for its transport by transferrin

Answer 11

Hephaestin

Question 12

Characterized by an anemia, often macrocytic, that is unresponsive to iron therapy, hypoferremia, neutropenia, and usually the presence of vacuolated erythroid and granulocytic precursors in the marrow

Answer 12

Copper deficiency

Question 13

Copper deficiency with a resultant microcytic anemia can be produced by

Answer 13

Chronic ingestion of massive quantities of zinc

Question 14

The diagnosis of copper deficiency can be established by demonstrating

Answer 14

Low serum ceruloplasmin or serum or 24-hour urine copper level

The serum copper level is thought to be more reliable because ceruloplasmin behaves as an acute phase protein.

Question 15

Low serum copper values may be observed in hypoproteinemic states, such as exudative enteropathies and nephrosis, and in Wilson disease.

In these circumstances, a diagnosis of copper deficiency cannot be established by serum measurements alone but requires analysis of

Answer 15

Liver copper content or clinical response after a therapeutic trial of copper supplementation

Question 16

TRUE OR FALSE

Although human zinc deficiency may produce growth retardation, impaired wound healing, impaired taste perception, immunologic abnormalities, and acrodermatitis enteropathica, at present, there is no evidence that isolated zinc deficiency produces anemia.

Answer 16

TRUE

Although human zinc deficiency may produce growth retardation, impaired wound healing, impaired taste perception, immunologic abnormalities, and acrodermatitis enteropathica, at present, there is no evidence that isolated zinc deficiency produces anemia.

Question 17

TRUE OR FALSE

Selenium deficiency results in a striking decrease in the level of red cell glutathione peroxidase, there do not appear to be any adverse hematologic consequences.

Answer 17

TRUE

Selenium deficiency results in a striking decrease in the level of red cell glutathione peroxidase, there do not appear to be any adverse hematologic consequences.

Question 18

A major factor responsible for the reduction in hemoglobin concentration in anemia of starvation

Answer 18

Dilution

Question 19

In persons subjected to complete starvation either for experimental purposes or as treatment of severe obesity, anemia was not observed during the first_____ weeks of fasting.

Answer 19

2–9 weeks

Question 20

In malnourished communities, anemia with erythroblastopenia resulting from _________ should be distinguished from the similar picture that can arise as a result of protein-calorie malnutrition.

Answer 20

Parvovirus B-19 infections

Question 21

TRUE OR FALSE

An abrupt fall in hemoglobin after protein feeding may be an ominous harbinger of adverse and even fatal outcome and prompt transfusion to restore hemoglobin may be lifesaving.

Answer 21

TRUE

An abrupt fall in hemoglobin after protein feeding may be an ominous harbinger of adverse and even fatal outcome and prompt transfusion to restore hemoglobin may be lifesaving.

It may respond to either riboflavin or prednisone.

Question 22

Deficiencies that are common in people with alcoholism

Answer 22

Pyridoxal phosphate and folate deficiency

Question 23

Condition where macrocytosis usually is mild, with mean cell volume in the range of 100–110 fl, and anemia is usually absent.

In the blood film, the macrocytes are typically round rather than oval, and neutrophil hypersegmentation is not present.

The macrocytosis persists until the patient abstains from this agent

Answer 23

Macrocytosis of alcoholism

Question 24

Alcohol ingestion for______ days produces vacuolization of early red cell precursors, and formation of vacuoles can be observed in in vitro marrow cell cultures.

Answer 24

5–7 days

Question 25

Condition characterized by alcohol-induced liver disease, often hyperlipidemia, jaundice, and transient spherocytic hemolytic anemia, and spur cell hemolytic anemia, associated with severe alcohol-induced liver disease

Answer 25

Zieve syndrome

Question 26

Treatment for Zieve syndrome

Answer 26

Hepatic transplantation

Question 27

The association of myelodysplasia with chronic alcohol consumption may result from polymorphisms in______________, which lead to accumulation of reactive aldehydes from ethanol, resulting in genetic damage to hematopoietic stem cells.

Answer 27

Alcohol dehydrogenase