Lecture 10 Chapter 18

Question 1

What characteristics have a low reticulocyte and high/increased MCV

Answer 1

Megaloblastic/macrocytic

Question 2

Macrocytic anemias effect

Answer 2

Production of DNA

Question 3

What is the first step when examining a blood smear

Answer 3

Look at reticulocytes and MCV

Question 4

What happens if you cannot synthesize thymine

Answer 4

Cannot produce thymidine → cannot make DNA → cells grow extra because they want to divide but cannot without enough thymidine

Question 5

What WBC commonly cannot divide due to lack of thymidine

Answer 5

Hypersegmented neutrophil

Question 6

What is a common cause of macrocytic anemias

Answer 6

Vitamin deficiency of b-12 and folic acid

Question 7

Answer 7

Hypersegmented neutrophil

Question 8

What do you do if you are uncertain if a segmented neutrophil is hypersegmented

Answer 8

Do not report it unless certain

Question 9

Symptoms/signs of megaloblastic anemia

Answer 9

Hypersegmented neutrophil
Ovalocytes
Decreased MCH
MCV may be 120
MCHC normal

Question 10

Where are vitamins stored in your body

Answer 10

Liver

Question 11

How much folate do you normally have stored

Answer 11

About enough for 1 week

Question 12

How long is b-12 stored for

Answer 12

About 1 year

Question 13

What food has the highest source of folate

Answer 13

Vegetables

Question 14

What is the only source of b-12

Answer 14

Animal products, red meat, meat

Question 15

Why must a pregnant woman take folate supplements

Answer 15

Folic acid deficiency in a pregnant woman will severely effect the fetus. Prevents the spinal cord from closing, most likely paralyzing the child

Question 16

What disease do you have it you cannot absorb b-12 but have plenty of it

Answer 16

Pernicious anemia

Question 17

What happens right after you absorb folate acid

Answer 17

It gets methylated

Question 18

Where does methyl-b12 come from

Answer 18

Folate acid

Question 19

H4-folate produces

Answer 19

Thymidine which allows for DNA synthesis

Question 20

What is the difference between homocysteine and methionine

Answer 20

Methionine has a methyl group

Question 21

Where does methionine get its methyl group

Answer 21

Methyl - b12

Question 22

What happens if you are deficient of b12

Answer 22

Homocysteine adds up/increases
Increase can cause cardiovascular disease
Methylmalonyl-coa adds up and can become methylmatonic acid
Cannot make DNA and RNA

Question 23

If you have microcytic anemia and your MMA (methylmalonic acid) increases, what is your conclusion

Answer 23

B12 deficiency
Increased homocysteine

Question 24

What is acetyl choline

Answer 24

A neurotransmitter in the brain

Question 25

What can cause folate deficiency

Answer 25

Lifestyle stressors Standard American diet Aging

Question 26

Folate deficiency causes what

Answer 26

Neural tube defects Infertility (sperm) Reduced methylation

Question 27

For b-12 deficiency what is the: MCV Smear Pernicious anemia? Homocystine Methylmalonic acid

Answer 27

> 100 Macrocytosis with hypersegmented neutrophils Yes Elevated Elevated

Question 28

For folate deficiency what is the: MCV Smear Pernicious anemia? Homocystine Methylmalonic acid

Answer 28

> 100 Macrocytosis with hypersegmented neutrophils No Elevated Normal

Question 29

What is pernicious anemia

Answer 29

B-12 goes into stomach → binds within intrinsic factor → travels to intestines → gets absorbed in the ileum

Question 30

What happens if b-12 does not bind to an intrinsic factor

Answer 30

It does not get absorbed in the ileum and travels through the feces

Question 31

What type of disease is pernicious anemia

Answer 31

Autoimmune It attacks the intrinsic factor and parietal cells

Question 32

What does gastric analysis look at

Answer 32

Acidity of stomach B-12 must be able to break off from food to bind with intrinsic factor

Question 33

What does your smear have to have to be megaloblastic

Answer 33

Hypersegmented neutrophils Ovalocytes