Lec 2

Question 1

What is the cause of B12 deficiency?

Answer 1

Low intake , damaged to parietal cell which produced IF , fall receptor to get B12 after bind to IF

Question 2

What is the haptocorrin?

Answer 2

Protein which bind to B12 in stomach to prevent acidity from destroy it

Question 3

Where haptocorrin separated from B12 and by what ?

Answer 3

In duadenum by protease enzyme which secreted from pancreas

Question 4

Where IF bind to B12 ?

Answer 4

In duadenum after destroyed haptocorrin

Question 5

Where IF and B12 separated from other ?

Answer 5

Terminal ilium which B12 bind to receptor in it (the site of absorption B12)

Question 6

What is the rout of administration of B12 supplement?

Answer 6

Orraly if there dietary deficiency and IM or sC of there pernicious anemia because there is deficiency in IF so destruction B12 in stomach

Question 7

What is mean by folic acid mask B12 .deficiency?

Answer 7

If we have B12 deficiency there are some neurological effect , so if we give folic acid we treated megaloblastic anemia but neurological effect not treatment

Question 8

Which cyanocoblamine or hydroxocoblamine is more effected ?

Answer 8

Hydroxycoblamine because it have rapid ones of action and long duration of action due to bind to protein in blood

Question 9

Erythropoietin produced in ? And what is the function of it ?

Answer 9

Kidney , regulated RBCs proliferation

Question 10

Where we use erythropoietin?

Answer 10

Anemia caused by RF
Anemia caused by viral infection ( virus effected kidney)
Anemia caused by metastasis cancer to kidney

Question 11

What is darbepoetin?

Answer 11

Long acting version of erythropoietin

Question 12

What is the characteristic of darbepoetin on erythropoietin?

Answer 12

Decreased clearance & long half life (3 time more)

Question 13

What is the rout of administration of darbepoetin?

Answer 13

IV in renal hemodialysis or SC

Question 14

What is the side effect of erythropoietin?

Answer 14

Vasoconstriction mainly in arterioles so there are increase in peripheral resistance which lead to hypertension
And may increased blood viscosity which lead to thrombosis
This two event increased if HB elevated more than 12 by erythropoietin administration so we must stopped it if we rich 12

Question 15

What is the value of HB elevated in 2 week treatment of Erythropoietin?

Answer 15

Less than 1 gram per dL in 2 week

Question 16

Painful crisis come with any type of anemia and what is the cause?

Answer 16

With sickle cell anemia , this due to sickle cell obstruction blood vessel

Question 17

What is the treatment of painful crisis?

Answer 17

Hydroxyurea

Question 18

What is the effect of hydroxyurea ?

Answer 18

Increased in HbF and decreased in HbS

Also it depression bone marrow

Question 19

What is the disease that hydroxyurea used in it ?

Answer 19

1-sickle cell anemia because it decreased of HbS
Myelogenous leukemia by depression of bone marrow (myelosupressive effect)
Polycythemia Vera (because it suppression bone marrow also)

Question 20

What is the side effect of hydroxyurea?

Answer 20

Myelosuppression and vasculitis

Question 21

In any cases we use pentoxifylline?

Answer 21

Sickle cell anemia with vasoocclusive crisis (vasoconstriction in peripheral blood vessel)

Question 22

What is the effect of pentoiphelline?

Answer 22

Increased cAMP which lead to vasodilation and relax of smooth muscle which lead to decreased peripheral resistance also increased cAMP lead to prevent platelets agergation which lead to decrease viscosity