B12 Deficiency

Question 1

COCP can lead to B12 deficiency True or false

Answer 1

False - it can lower b12 levels without causing deficiency

Question 2

What type of anaemia does low b12 cause

Answer 2

Macrocytosis

Question 3

B12 if pregnant always measure in what way?

Answer 3

Serum holotranscobalamin

Question 4

If NO use and meauring for b12 deficiency what type should be used?

Answer 4

Plasma homocysteine
Serum methylmalonic acid (MMA)

Question 5

Name two drugs that can impair B12 absorption

Answer 5

Metformin and PPI

Question 6

Always correct b12 deficiency before folate True or false

Answer 6

True - at least 24) (b before f)

Question 7

If neurological symptoms then urgent treatment, don’t wait for bloods. True or false

Answer 7

True

Question 8

What can b12 cause due to new call formation

Answer 8

Hypokalaemia

Question 9

What is the b12 dose and drug to use if pernicious anaemia or malabsorption?

Answer 9

1mg IM alternative days for 2 weeks then 1mg IM every 3 months

IM Hydroxycobalamin

(If neurological involvement keep doing alternate days until symptoms stop improving)

Question 10

What is the drug and dose for b12 deficiency caused by dietary deficiency?

Answer 10

Oral cyanobobalamin 50-150mcg daily
IM if oral not tolerated or if neurological symptoms

Question 11

B12 deficiency in pregnancy - what dose and how

Answer 11

1mg/day oral or if autoimmune gastritis suspected then IM