Macrocytic anaemia Flashcards
1
Q
what are the causes of macrocytic anaemia?
A
- Medication
- Alcoholism
- B12 deficiency
- Folate deficiency
2
Q
what are the causes of B12 deficiency?
A
- autoimmune pernicious anaemia
- GI surgery
- Infection
- Dietary (vegans)
3
Q
What are the causes of folate deficiency?
A
- dietary
- malabsorption
- blood malignancy
- drug induced (alcohol, anticonvulsants, methotrexate)
4
Q
what is the difference between megaloblastic and non megaloblastic macrocytic anaemia?
A
- megaloblastic anaemia is a direct result of impaired DNA synthesis (but RNA synthesis not impaired so build up of intracellular components making it big)
- non-megaloblastic no DNA synthesis inhibition
5
Q
why do you get macrocytosis in chronic alcoholism?
what about COPD?
A
- due to direct toxicity on the bone marrow
- excess C02 retention causes cell water retention
6
Q
what investigations would you do?
what would a raised reticulocyte count indicate?
A
- FBC and Blood film
- LFTs (ETOHXS)
- Folate and B12 levels
- Bone marrow examination
- rapid turnover
7
Q
how do you manage B12 deficiency?
Folate?
A
- hydroxycobalamin
- 5mg folic acid
- refer if assumed haematological malignancy
