14 2 a

Question 1

Megaloblastic Anaemia’s

Answer 1

Presence of large RBC’s impaired by
DNA synthesis
Absence of intrinsic factor (IF)

Question 2

Absence of intrinsic factor (IF) anaemia

Answer 2

◦ A protein secreted by the parietal
cells of the gastric mucosa which
is required for cobalamin (Vit B
12) absorption in distal ileum

Question 3

Megaloblastic Anaemia’s cause and can result

Answer 3

◦ Caused by impaired DNA synthesis
◦ Can result from deficiency in
◦ Vitamin B12
◦ Folic acid

Question 4

Vit B 12 Deficiency: signs and symptoms

Answer 4

§ General signs and symptoms of anaemia
develop slowly due to tissue hypoxia.
§ Gastrointestinal manifestations
◦ Sore tongue, nausea, vomiting, and pain
Neuromuscular manifestations
◦ Weakness, paresthesias of feet & hands,
↓ vibratory and position senses, ataxia,
muscle weakness, and impaired thought
processes

Question 5

Vit B 12 Deficiency diagnostic studies

Answer 5

◦ Bloods

◦ Upper GI endoscopy

Question 6

Multidisciplinary care Megaloblastic Anaemia’s

Answer 6

§ Intramuscular, parenteral or intranasal
administration of cobalamin (Vit B 12)
◦ Initially, IM injections for 2 weeks daily
◦ Need monthly injections for life if GI tract not
absorbing B12 in the ileum.
◦ This anaemia can be reversed with ongoing
treatment but long-standing neuromuscular
complications may not be reversible

Question 7

Folate

Answer 7

It is required for DNA synthesis.

◦ RBC formation and maturation

Question 8

Folate deficiency signs

Answer 8

§ Signs and symptoms are similar to those of cobalamin deficiency, but absence of
neurologic problems differentiates them.

Question 9

Folate deficiency causes

Answer 9

§ Dietary deficiency
§ Malabsorption syndromes
§ Drugs
§ Increased requirement 
§ Alcohol abuse and anorexia 
§ Loss during haemodialysis

Question 10

Folate deficiency diagnostic studies

Answer 10

◦ Serum folate level is low.
◦ Normal is 3 to 25 mg/mL (7 to 57 mol/L).
◦ Serum cobalamin level is normal.

Question 11

Folate in foods

Answer 11

Ø Dark leafy greens
Ø Asparagus
Ø Citrus foods
Ø Broccoli
Ø Avocado
Ø Beans, nuts, legumes
Ø Eggs
Ø Fortified breads and cereals
* Folic Acid is the synthetic form of Vit B 9

Question 12

Multidisciplinary care Folate deficiency

Answer 12

§ Early detection and treatment 
§ Ensure safety 
◦ Diminished sensations to heat and pain from neurologic impairment
§ Focus on compliance with treatment
§ Regular screening for gastric cancer