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MDTI > B12/Folate Deficiencies > Flashcards

B12/Folate Deficiencies Flashcards

1
Q

other name for B12?

A

cobalamin

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2
Q

other name for folate?

A

vitamin B9

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3
Q

how do we obtain b12?

A

can’t synthesize it, so it must come from diet (animal proteins, dairy) –> vegans need supplements

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4
Q

how do we obtain folate?

A

we synthesize it and obtain it from vegetables, nuts, dairy, meat

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5
Q

what’s wrong with a B12 deficiency?

A

b12 is crucial to folate synthesis

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6
Q

whats wrong with a folate deficiency?

A

without it, body cant synthesize thymine and therefore cant synthesize DNA

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7
Q

how can you distinguish between a folate or B12 deficiency?

A

methylmalonic acids levels will only be elevated if B12 is deficient

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8
Q

function of B12

A

cofactor for tetrahydrofolate (THF) production, for methionione production from homocysteine (HCY), & for succinyl coA from methylmalonyl (MMA)

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9
Q

tests for B12 deficiency

A

decreased THF, increased HCY & MMA

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10
Q

hematologic symptoms of B12/folate deficiency

A

megaloblastic anemia, low platelets, leukopenia

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11
Q

dermatologic symptoms of B12/folate deficiency

A

rashes, hyperpigmentation, epithelial atrophy

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12
Q

oral/GI symptoms of b12/folate deficiency

A

diarrhea, malabsorption, chelitis, glossitis

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13
Q

neuropsychiatric symptoms of b12/folate deficiency

A

neural tube defects, ataxia, paresthesias, megalobastic madness, depression blindness

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14
Q

what can mask symptoms of b12 deficiency?

A

supplementing folate

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15
Q

intrinsic factor

A

secreted from gastric parietal cells. promotes absorption of cobalamin in ileum

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16
Q

transcobalamin 2

A

transports cobalamin to cells

17
Q

R proteins

A

protect B12 from degradation in the stomach

18
Q

where is folate absorbed?

A

jejunum

19
Q

where is b12 absorbed?

A

ileum

20
Q

where is iron absorbed?

A

duodenum

21
Q

Lab results for B12 deficiency

A

increased MMA & HCY, decreased reticulocytes

22
Q

cause of B12 deficiency if B12 injection is curative?

A

nutritional deficiency

23
Q

cause of B12 deficiency if injection doesn’t cure & IF infusion does

A

gastric pernicious anemia

24
Q

cause of B12 deficiency if B12/IF infusions don’t work, but antibiotics do

A

abnormal bacterial growth in intestines

25
Q

cause of B12 deficiency if B12/IF/antibiotics don’t work, but addition of pancreatic enzymes does

A

pancreatic insufficiency

26
Q

pernicious anemia

A

autoimmune condition that destroys gastric parietal cells so that IF isn’t available for binding and absorption.

27
Q

megaloblastic anemia

A

macrocytic anemia caused by impaired DNA synthesis and nuclear/cytoplasmic maturity imbalance (nucleus is less mature). shortened life

28
Q

types of microcytic anemia

A

iron deficiency, thalassemia, anemia of inflammation

29
Q

types of normocytic anemia

A

acute blood loss, bone marrow failure, renal disease, sickle cell disease

30
Q

types of macrocytic anemia

A

B12/folate deficiency, autoimmune hemolytic (pernicious) anemia, hypothyroidism, antimetabolites

31
Q

causes of megaloblastic anemia

A

B12, folate deficiency, antimetabolites

32
Q

morphology of megaloblastic anemia

A

RBCs with mature pink cytoplasm, with dark condensed nucleus. hyper segmented neutrophils.

33
Q

problems that lead to hyper segmented neutrophils

A

megaloblastic anemia & iron deficient anemia

34
Q

how severe are the neuropsychiatric pathologies associated with b12 deficiency?

A

irreversible if b12 deficient for >6mos

35
Q

effects of b12 deficiency on myelin

A

elevated levels of MMA destabilize myelin

36
Q

subacute combined degeneration of spinal cord

A

progressive onset due to loss of myelination from b12 deficiency.

37
Q

treatment for b12 deficiency

A

parenteral b12, IM B12 for more severe cases

38
Q

treatment for pernicious anemia

A

oral B12 in high dose following parenteral replacement (can absorb some due to laws of mass action)

39
Q

treatment for folate deficiency

A

oral folate

MDTI (42 decks)

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