Macrocytic Anaemia Flashcards

1
Q

What is macrocytic anaemia?

A

Reduced RBCs with larger volume than expected.

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2
Q

What are the 2 sub-types of macrocytosis?

A

Megaloblastic

Non-megaloblastic

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3
Q

What are RBC precursors that contain a nucleus?

A

Erythroblasts

Normoblasts

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4
Q

What is a megaloblast?

A

An abnormally large nucleated RBC precursor that contains an immature nucleus.

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5
Q

What is the cause of megaloblastic anaemia?

A

Defects in DNA synthesis and nuclear maturation.

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6
Q

What occurs in megaloblast maturation?

A

Cell division with an increased rate of apoptosis.

Triggering of Hb threshold occurs, pushing out the cell nucleus, creating a macrocyte.

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7
Q

What are the 2 main causes of macrocytic anaemia?

A

B12 deficiency

Folate deficiency

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8
Q

What chemicals are important in preventing megaloblastic anaemia?

A

Folate and vitamin B12.

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9
Q

What binds to vitamin B12 in the stomach and carries it to the duodenum?

A

Rapid binding proteins

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10
Q

After the dudoenum, what carries B!”?

A

Intrinsic factor

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11
Q

Where is vitamin B12 absorbed?

A

The ileum

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12
Q

What is pernicious anaemia?

A

Autoimmune destruction of gastric parietal cells - results in an inability to secrete intrinsic factor.

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13
Q

What is the result of pernicious anaemia?

A

B12 deficiency.

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14
Q

What conditions are linked to pernicious anaemia?

A

Hypothyroidism
Vitiligo
Addison’s disease

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15
Q

In which food is vitamin B12 found?

A

Animal food

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16
Q

In which food is folate found?

A

Plant food

17
Q

What can cause folate deficiency?

A

Inadequate dietary intake
Malabsorption
Excess utilisation

18
Q

Where is folate absorbed?

A

The jejunum

19
Q

What sign is specific to B12 deficiency?

A

Neurological issues

May lead to subacute spinal cord compression.

20
Q

What are features seen in both folate and vitamin B12 deficiencies?

A
Signs/Symptoms of anaemia
Weight loss
Diarrhoea
Infertility
Sore tongue
Developmental issues
21
Q

What are the symptoms common to all anaemias?

A

Fatigue
SOB
Impaired concentration

22
Q

What are causes of non-megaloblastic macrocytic anaemia?

A

Alcohol
Liver disease
Hypothyroidism
Bone marrow failure

23
Q

What are causes of false macrocytosis?

A

Reticulocytosis

Cold-agglutins

24
Q

What is the cause of cold-agglutins?

A

Abnormal protein

Clumping of RBCs due to storage at colder temperature than body temperature.

25
Q

How is pernicious anaemia screened for?

A

Check for presence of autoantibodies.

26
Q

Can macrocytic anaemia cause jaundice?

A

Yes, as macrocytes cannot pass through openings as easily.

27
Q

Can B12/Folate deficiency cause pancytopenia?

A

Yes, as absence of these increases apoptosis of all cell type precursors.