Anemia (Macrocytic) Flashcards
Examples of Megaloblastic Anemia
Vit B12 deficiency
Folic Acid Deficiency
Non-Megaloblastic Anemia:
Examples
Liver disease
Chronic alcoholism
Bone Marrow Failure
Reticulocytosis
Normal macrocytosis of newborns
Megaloblastic anemia:
DNA metabolism
defective
Non-Megaloblastic anemia:
DNA metabolism
Normal
Megaloblastic Anemia:
MCV:
↑ 100-150fl
Megaloblastic anemia:
Pancytopenia
+
Non-Megaloblastic anemia:
Pancytopenia
-
Megaloblastic anemia:
Macro-ovalocytes
+
Non-Megaloblastic anemia:
Macro-ovalocytes
-
Megaloblastic anemia:
Hyper-segmented neutrophils
+
Non-Megaloblastic anemia:
Hyper-segmented neutrophils
-
Vit B12 Deficiency:
Serum Vit B12
↓
Folic Acid Deficiency:
Serum Vit B12
N
Vit B12 Deficiency:
Serum Folate
Normal
Folic Acid Deficiency:
Serum Folate
↓
Vit B12 Deficiency:
Serum Methylmalonic
acid
↑
Folic Acid Deficiency:
Serum Methylmalonic
acid
Normal
Vit B12 Deficiency:
Serum Homocysteine
↑
Folic Acid Deficiency:
Serum Homocysteine
↑
Vit B12 Deficiency:
Schilling’s Test
+
Folic Acid Deficiency:
Schilling’s Test
-
Vit B12 Deficiency:
Autoantibody to
parietal cells / IF
+
Folic Acid Deficiency:
Autoantibody to
parietal cells / IF
-
Vit B12 Deficiency:
Gastric analysis:
Achlorhydia
Folic Acid Deficiency:
Gastric analysis:
Euchlorhydia
radioactive test for assessment of measurement of vit B12
Schilling’s test
absence of gastric acidity
Achlorhydia
Root cause of Megaloblastic anemia is Impaired DNA metabolism which leads to cells division ______, _____ of progenitors in the bone marrow, ______ development
Failure
Apoptosis
Asynchronous
Folate (pteroylglutamic acid) deficiency caused by:
* ____ intake
* _____ need, (such as in pregnancy)
* Impaired ____
* _____ protein deficiency
* drugs that impair _____
* Excessive ____ of folate
Inadequate
Increased
Absorption
Folate transporter
folate metabolism
Loss
Vitamin B12 (Cobalamin) deficiency caused by:
Competition for Vit. B12, (w/ _____)
Diphyllobothrium latum
Vitamin B12 (Cobalamin) deficiency caused by:
Defective production of intrinsic factor due to _______ infection
Helicobacter pylori
Vitamin B12 (Cobalamin) deficiency caused by:
______ anemia
- Associated to ______ and _______
Pernicious
anti-parietal cell
anti-Intrinsic factor autoantibody
Pernicious anemia symptoms:
Skin pallor
Jaundice
Peripheral neuropathy
Emotional instability
Atrophic gastritis
MEGALOBLASTIC ANEMIA
Laboratory Findings: MCV
Macrocytosis
MEGALOBLASTIC ANEMIA
Laboratory Findings: Blood smear
Macroovalocytes
hypersegmented neutrophils
Howell-Jolly (DNA
Remnants)
Cabot rings (mitotic spindle remnants)
MEGALOBLASTIC ANEMIA
Laboratory Findings: CBC
Pancytopenia
Reticulocytopenia
MEGALOBLASTIC ANEMIA
Laboratory Findings: Chemistry
↑ Serum B1 and LDH
MEGALOBLASTIC ANEMIA
Laboratory Findings: Schilling Test
can detect absence of IF, but uses radioactive cobalamin
MEGALOBLASTIC ANEMIA
Laboratory Findings: Bone Marrow Exam
Nuclear-cytoplasm asynchrony in cells
Large Progenitors (RBC and WBC)
Hypercellular Bone Marrow with increased apoptosis
Reference Confirmatory test of megaloblastic anemia
Bone Marrow Exam