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Flashcards in Macrocytic anaemia Deck (12):
1

Classes of macrocytic anaemias and give examples of causes of each

Megaloblastic: B12 deficiency, folate deficiency, hydroxycarbamide
Non-megaloblastic: liver disease, alcohol, reticulocytosis, myxoedema/hypothyroidism, myelodysplasia

2

Causes of B12 deficiency anaemia

Poor dietary intake (veganism)
Pernicious anaemia
Gastrectomy
Terminal ileum resection
Chron's
Coeliacs

3

Clinical features of B12 deficiency anaemia

Glossitis
Mild jaundice + pallor = lemon tinge
Peripheral neuropathy
Subacute combined degeneration of the spinal cord (symmetrical dorsal column loss, corticospinal tract loss)
Depression

4

Antibodies present in B12 deficiency anaemia

Parietal cell antibodies in 90%
Intrinsic factor antibodies in 50% (more specific)

5

What's associated with pernicious anaemia

B12 deficiency anaemia
Vitiligo
Addisons
Thyroid disease
Gastric adenocarcinoma

6

Treatment for B12 deficiency anaemia

Parenteral hydroxacobalamin for peripheral neuropathy or malabsorption
Oral cyanocobalamin for dietary

7

Causes of folate deficiency anaemia

Poor dietary intake
Pregnancy
Coeliac
Haemolysis
Malignancy
Methotrexate
Alcohol
Phenytoin

8

Where is folate absorbed

Jejunum

9

Where is B12 absorbed

Terminal ileum

10

Treatment for folate deficiency anaemia

Treat underlying cause
Give folic acid OD for 4 months WITH B12 SUPPLEMENTS UNLESS B12 NORMAL (folate alone can precipitate SCAD)

11

What foods contain folate

Nuts
Liver
Green veg
Yeast

12

What foods contain B12

Meat
Fish
Dairy