B12 And Folate Deficiency

Question 1

Give some specific signs for iron deficiency anaemia.

Answer 1

Kolionychia
Oesophageal webs
Angular stomatitis

Question 2

Name to drugs which cause folate deficiency.

Answer 2

Methotraxoate

Trimethoprim

Question 3

What drugs can cause B12 deficiency?

Answer 3

Antacids and PPIs

Can not seperate HC from B12

Question 4

Give 4 features of a megaloblastic blood film

Answer 4

Hypersegmented neutrophils
Anisopoikilocytosis with tear drops
Macrocytics RBCs
White cell precursors

Question 5

What is B12 deficiency associated with that folate isn’t in terms of disease?

Answer 5

Neurological disease

Subacute degenerate and focal demyelination

Question 6

How would you investigate vitamin B12 and folate deficiency?

Answer 6

Hb - low 
MVC - high 
Blood film 
High bilirubin and LDH 
B12 and serum folate at the same time 
(Repeat b12 if borderline because poor test)
Indeterminate 
Check tHcy and MMA 
Check anti-IF ABs

Question 7

Name two drugs that can cause hypokalaemia.

Answer 7

Hydroxycobalamin

Cyanocobalamine

Question 8

After treatment begins what improvements would be seen at 14days, 2 months and 3-6 months?

Answer 8

14 days - dissapearance of hypersegemented neutrophils
2 months - anaemia resolution
3-6 months - neuropathy resolution