Module 3

Question 1

Megaloblastic anemias

Answer 1

Anemias characterized by a macrocytic anemias of peripheral blood and a megaloblastic bone marrow
Cause is impaired DNA synthesis in the differentiation cells of the erythroid series that produces a nuclear/cytoplasmic asynchrony

Question 2

2 main classifications of macrocytic anemias

Answer 2

Megaloblastic macrocytic anemias

Non-megaloblastic macrocytic anemias

Question 3

Pernicious anemia

Answer 3

An autoimmune disorder with autoantibodies against parietal cells or against intrinsic factor
Intrinsic factor is not available to bind with Vitamin B12, so B12 cannot be absorbed

Question 4

Treatment for pernicious anemia

Answer 4

Injection of vitamin B12

Question 5

Hypersegmented neutrophils in a peripheral blood smear indicates:

Answer 5

Megaloblastic anemia

Question 6

Vitamin B12 and folate deficiencies can lead to what type of anemia

Answer 6

Megaloblastic macrocytic anemia

Question 7

RBC morphology in megaloblastic anemias

Answer 7

Oval macrocytes; in severe cases, Howell-Jolly bodies, basophilic stippling, and Cabot rings may be present

Question 8

Reticulocyte count in a megaloblastic anemia

Answer 8

Decreased (ineffective erythropoiesis)

Question 9

RBC indices in a megaloblastic anemia

Answer 9

MCV and MCH increased, MCHC normal

Question 10

2 major forms of megaloblastic anemias

Answer 10

Vitamin B12 Deficiency anemia

Folic acid deficiency anemia

Question 11

WBC count and morphology in a megaloblastic anemia

Answer 11

Decreased WBC count (leukopenia) especially neutrophils (neutropenia). Atypical neutrophils appear first: macropolycytes (hypersegmented) and rare large giant band cells, both with decreased specific granulation

Question 12

Oval macrocytes in a peripheral blood smear are characteristic of:

Answer 12

Megaloblastic anemia

Question 13

Platelet count and morphology in a megaloblastic anemia

Answer 13

Decreased platelet count (thrombocytopenia) and pleomorphic (vary in size)

Question 14

Findings in bone marrow of megaloblastic anemia

Answer 14

Hypercellular (or normocellular) with up to 50% megaloblasts showing karyorrhexis and Howell-Jolly bodies. Decreased numbers of leukocytes and megakaryocytes but increased in size

Question 15

Karyorrhexis

Answer 15

Nuclear fragmentation

Question 16

Why are vitamin B12 and folic acid required for DNA synthesis?

Answer 16

They are coenzymes required in the normal conversion of uridine into thymidine, an essential component of DNA

Question 17

Another name for vitamin B12

Answer 17

Cobalamin

Question 18

Foods that contain vitamin B12

Answer 18

Foods of animal origin: liver, fish, poultry, meat, eggs, dairy

Question 19

Foods that contain folic acid

Answer 19

Leafy green vegetables, fruit, beans, peas, dairy, meat (liver and kidney)