B12 defiency Flashcards

1
Q

Role of B12 in the body?

A

mainly used in the body for red blood cell development and also maintenance of the nervous system.

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2
Q

How is B12 absorbed?

A

absorbed after binding to intrinsic factor (secreted from parietal cells in the stomach) and is actively absorbed in the terminal ileum. A small amount of vitamin B12 is passively absorbed without being bound to intrinsic factor.

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3
Q

Causes of vitamin B12 deficiency

A

pernicious anaemia: most common cause

post gastrectomy

vegan diet or a poor diet

disorders/surgery of terminal ileum (site of absorption)
- Crohn’s: either diease activity or following ileocaecal resection

metformin (rare)

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4
Q

Features of vitamin B12 deficiency

A

macrocytic anaemia

sore tongue and mouth

Neurological symptoms
- the dorsal column is usually affected first (joint position, vibration) prior to distal paraesthesia

  • Neurophsyciatric symptoms eg. mood disturbances
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5
Q

Features of vitamin B12 deficiency

A

macrocytic anaemia

sore tongue and mouth

Neurological symptoms
- the dorsal column is usually affected first (joint position, vibration) prior to distal paraesthesia

  • Neurophsyciatric symptoms eg. mood disturbances
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6
Q

Management: B12 deficiency

A

if no neurological involvement 1 mg of IM hydroxocobalamin 3 times each week for 2 weeks, then once every 3 months

if a patient is also deficient in folic acid then it is important to treat the B12 deficiency first to avoid precipitating subacute combined degeneration of the cord

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