B12

Question 1

b12 tests

Answer 1

low haemoglobin, and mean cell volume

Question 2

what do you need to absorb b12

Answer 2

• IF, normal ileum, hcl, pancreatic enzymes
• stomach problem - lack of IF, autoimmune disorders - antibodies against IF and parietal cells
• Note enough IF to bind to B12, which means b12 cannot be absorbed later on in the SI
• small intestine problem -malabsortpion, surgery to removed terminal ilium

Question 3

Signs of autoimmune gastritis

Answer 3

Antibodies to paritenal cells, IF
evidence of low acid outpuut, autoimmune diseases
-can test for antibodies
-also can be caused by loss of specialised receptors on terminal ileum

Question 4

treatment

Answer 4

take many years to run out, so need high does

• will need injection if impared absorption of GI tract
• monitor to see if b12 is increasing - increase haemoglobin and resolution of neurological symptoms

Question 5

What can happen with terminal ilieum removal?

Answer 5

loss of absorption of b12 because this is where receptors are
-iritaitoon of bile on colon, also fat malabsrption

Question 6

what can happen with gaastrocetomy

Answer 6

may remove g cells - these secrete gastrin, this stimulates ecl and pariteal cells to increase acid produciton, if not enough acid then cannot digest acid and cannot get removal or r binders
-gastrin also plays a role in stimulating pancreatic enzymes

Question 7

causes of b12 deficinecy

Answer 7

coeliac disease
terminal ileal disease - crons or removal
bacterial overgrowht - bacteria competes for b12
chronic pancreatitis
total gastrecetomy

Question 8

signs of aneamia

Answer 8

shortness of breath and tiredness

Question 9

Pylorus or antrum removed

Answer 9

-antrum - no g cells, low gastrin, reduced gastric acid secretion
Pylorus - bile may come back up into stomahc, and destroy parietal cells