FOLATE AND B12 DEFICIENCY Flashcards
What type of anaemia is caused by B12 and Folate deficiency?
Megaloblastic Macrocytic Anaemia
What is folate deficiency anaemia caused by?
Poor diet, increased demand (pregnancy, malignancy, haemolysis), malabsorption, alcohol, drugs (anti-epileptic)
Folate is Vitamin 9 and used for making DNA and genetic material (found in fruits and leafy green veg and liver)
What causes B12 deficiency?
Dietary (vegans), malabsorption, congenital metabolic error
Vitamin B12 is used for synthesis of DNA and found in meat, eggs and milk
What are the signs and symptoms of folate?
SYMPTOMS:
reduced sense of taste, diarrhoea and depression
SIGNS:
Muscle weakness, numbness and tingling in feet and hands
What are the signs and symptoms of B12 deficiency anaemia?
SYMPTOMS: glossitis and angular cheilosis Disturbed vision Irritability Depression
SIGNS: psychosis Declined mental ability (dementia) Pale yellow tinge skin Neurological triad Ataxia followed with stiffness and weakness
What is the neurological triad of B12 deficiency anaemia?
Extensor plantars, absent knee and ankle jerks
What does a blood test show in Macrocytic deficiency anaemia?
Serum B12: low Serum Folate: low MCV: high MCHC: normal LFT: signs of liver disease TFT: signs of hypothyroidism
What would blood films show in Macrocytic Deficiency Anaemia?
Hypersegmented neutrophils
Oval macrocytes
If blood film reveals round macrocytes what does this indicate?
Alcoholism of liver disease cause
What would a bone marrow biopsy show in Macrocytic Deficiency Anaemia?
Megaloblastic marrow
What is the first line treatment of Macrocytic Deficiency Anaemia?
Hydroxocobalamin + Folic acid
SE: diarrhoea, skin reactions, urine discolouration, headache
Folic acid is used for 4months on Folate deficiency
Why is B12 needed when treating folate deficiency anaemia?
A high level of folate with low B12 can causes cord degeneration
What is Pernicious Anaemia?
Autoimmune condition which atrophic gastritis leads to lack of IF secretion in the stomach so dietary B12 remains unbound and can’t be absorbed
Seen alongside thyroid disease, can I Ona of stomach, hypoparathyroidism
How do you investigate for PA?
IF Ab: positive
APC Ab: positive
