[b12/pernicious] Flashcards Preview

HAEMATOLOGY > [b12/pernicious] > Flashcards

Flashcards in [b12/pernicious] Deck (28):
1

[b12/pern]: where is B12 found (3)

meat
fish
dairy

2

[b12/pern]: body stores of B12 are?

4 years

3

[b12/pern]: B12 is absorbed bound to what?

intrinsic factor

4

[b12/pern]: synthesis of DNA is blocked in B12 deficiency due to inability to synthesis

thymidine

5

[b12/pern]: what 3 things can contribute to stomach mediated malabsorption

pernicious anaemia
gastrectomy
low IF

6

[b12/pern]: [b12/pern]: what 5 things can contribute to terminal ileum mediated malabsorption

ileal resection
Crohns
coeliacs
bacterial overgrowth
tapeworm

7

[b12/pern]: B12 deficiency may present with what 2 facial features

angular stomatitis
glossitis (beefy-red sore tongue)

8

[b12/pern]: Sub-acute combined degeneration of the spinal cord presents with

peripheral neuropathy

9

[b12/pern]: what is SACDSC due to

B12 deficiency

10

[b12/pern]: which tracts are affected in SACDSC (2)

symmetrical dorsal and corticospinal tracts

11

[b12/pern]: which tract loss in SACDSC presents first

dorsal - joint position/vibration sense (ataxia)

12

[b12/pern]: if SACDSC is left untreated another tract may finally be affected. How does it present.

weakness

13

[b12/pern]: what is the classical triad for SACDSC

extensor plantars
Lost reflexes at :
ankle
knee

14

[b12/pern]: which tracts in SACDSC often remain intact regardless of severity

Spinothalamic (P+T)

15

[b12/pern]: what is the pathophysiology behind pernicious anaemia (3 points)

Atrophic gastritis (autoimmune)
Loss of IF
achlorhydria

16

[b12/pern]: which blood group is associated with pernicious anaemia

A

17

[b12/pern]: Why in pernicious anaemia should you have a low threshold for gastroscopy i.e. what is it associated with?

carcinoma of stomach

18

[b12/pern]: What type of anaemia does it causes

macrocytic

19

[b12/pern]: what would be seen on blood films

hypersegmented polymorphs

20

[b12/pern]: would you see raised reticulocytosis

NO - production is stopped
it will be reduced or normal

21

[b12/pern]: Name 2 specific tests for pernicious anaemia

pareital cell antibodies (found in 90%, also 10% without)
Intrinsic factor antibodies (specific but lower sens)

22

[b12/pern]: below what age would pernicious anaemia be uncommon

<40

23

[b12/pern]: Tx: 1st line?

Hydroxycobalamin 1mg IM

(alternate days for 2 weeks)

1mg IM every 3 months for life

24

[b12/pern]: Tx: how frequently and for how long should you inject B12

alternate days every 2 week s

25

[b12/pern]: Tx: what is maintenance for B12 deficiency

1mg IM hydroxycobalamin every 3 months

26

[b12/pern]: Tx: how can you check that improvement from treatment has occured?

reticulocytosis after 5 days (therefore increased MCV)

27

[b12/pern]: B12 deficiency/poor diet and falls at night might suggest what?

SACDSC

28

[b12/pern]: Tx: if the cause is dietary what can you revert to after the initial 2 weeks on IM injections

oral b12