Folate deficiency Flashcards
What is folate (B9) absorbed as?
1 - folic acid
2 - cobalamin
3 - methylfolate
4 - tetrahydrofolate (THF)
4 - tetrahydrofolate (THF)
Concerted into THF in the epithelial cells of the jejunum
Once tetrahydrofolate (THF) has been absorbed the majority enters the blood stream to be used for metabolic activity. Where can some of the THF be stored for a period of 2-3 months?
1 - spleen
2 - liver
3 - kidney
4 - bone
2 - liver
How long can we last with the folate stored in our body?
1 - 1-3 weeks
2 - 2-3 months
3 - 3-6 months
4 - 6-12 months
2 - 2-3 months
Folic acid is essential for cells to synthesise the precursors for DNA replication and cell division. Which of the following can folate deficiency cause?
1 - impaired cell division
2 - increased homocysteine
3 - neural tube defects (NTD)
4 - all of the above
2 - liver
In women at higher risk of conceiving a child with a NTD should take 5mg of folic acid from before conception until the 12th week of pregnancy
Excessive homocysteine can lead to atherosclerosis
What is the leading cause of folate deficiency?
1 - malabsorption/inadequate intake
2 - surgery
3 - drug induced
4 - congenital
5 - increase in requirement
1 - malabsorption/inadequate intake
Cell division is impaired in folate deficiency, which of the following cells are most commonly affected?
1 - RBCs
2 - WBCs
3 - platelets
4 - all of the above
4 - all of the above
Pancytopenia may occur
Which of the following does folate (B9) deficiency cause in relation to anaemia?
1 - microcytic anaemia <80fL
2 - normocytic anaemia 80-100fL
3 - macrocytic anaemia >100fL
3 - macrocytic anaemia >100fL
Often destroyed by the spleen, causing anaemia
Bone marrow compensates by producing Megaloblasts
Which of the following drug does NOT cause folate deficiency?
1 - phenytoin
2 - methotrexate
3 - sulfasalazine
4 - metoclopramide
1 - phenytoin
2 - methotrexate
Alcohol excess can also cause folate (B9) deficiency
Which 2 of the following symptoms does folate (B9) deficiency?
1 - glossitis
2 - oral ulcers
3 - enlarged parotid gland
4 - dupuytren’s contracture
5 - angular cheilitis
1 - glossitis
5 - angular cheilitis
Epithelial cells of tongue are continually being turned over and require B12. Without this the tongue can become inflamed.
Patients with folate (B9) deficiency may present with which if the following basic symptoms?
1 - general illness
2 - fatigue and weakness
3 - pallor (due to anaemia)
4 - light headedness
5 - SOB
6 - all of the above
6 - all of the above
Does folate (B9) deficiency only affect RBCs?
- No
Typically RBCs are affected 1st, but can cause pancytopenia (RBC, WBC and Platelets)
To diagnose folate deficiency a FBC with a blood smear can be performed. We may see all of the following EXCEPT which one?
1 - megaloblasts
2 - normocytic anaemia
3 - increased homocysteine
2 - normocytic anaemia
We would see macrocytosis
Once diagnosis is made, the cause needs o be identified:
- low dietary intake
- pregnancy
- medication
- alcohol
If a patient is diagnosed with folate deficiency, they should be given folic acid. What is the dosage of folic acid in adults without a malabsorption state?
1 - 5 mg of folic acid daily for four months
2 - 5 mg of folic acid daily for life
3 - 5 mcg of folic acid daily for four months
4 - 25 mg of folic acid once a week for a year
1 - 5 mg of folic acid daily for four months
- 5 mg daily may be required in malabsorption states
- Maintenance is 5 mg every 1-7 days.
In pregnancy, how much folic acid should patients be advised to take?
1 - 5mg/daily
2 - 2.5mg/daily
3 - 1000mcg/daily
4 - 400mcg/daily
4 - 400mcg/daily
Women at higher risk of pregnancy abnormalities or with other comorbidities should be on 5mg/day
Advising diets high in folate, and eating foods fortified with folate should also be advised
