Haematology 3 - Pernicious Anaemia

Question 1

explain pernicious anaemia

Answer 1

either intrinsic factor or parietal cells attacked

so poor absorption of B12

Question 2

4 symptoms of B12 deficiency aside from anaemia

Answer 2

peripheral neuropathy + parasthesiae
loss of vibration sense or proprioception
visual changes
mood/cognitive changes

Question 3

if you see peripheral neuropathy, always test for 2 things

Answer 3

diabetes

B12

Question 4

antibodies involved in pernicious anaemia

Answer 4

IF Ab

gastric parietal cell Ab

Question 5

treatment of b12 def

Answer 5

if deficient only - cyanocobalamin orally

if due to pernicious A
- 1mg IM hydroxycobalamin 3 x weekly for 2 weeks, then 3 monthly

more intense regime if neuro signs

Question 6

crucial thing to know when replacing folate when deficient

Answer 6

must ALWAYS replace B12 before folate

or can cause subacute combined degeneration of the cord