LEC 6 Flashcards
def? root cause is impaired DNA synthesis, very large cells in BM
dermatologic effect
what vitamins are important in DNA synthesis
vit B12 and folic acid
in MA what is the issue
thymidine nucleotide synthesis
is uracil a nucleotide in DNA or RNA
RNA only
in MA is it ineffective hematopoiesis or insufficient hematopoiesis
ineffective hematoopoiesis
what is the structure of B12
tetrapyrrole
what is the term for folate in food/supplements
folic acid
what is increased in the serum of someone with vit B12 deficiency
MMA
what enzyme generates methionine
methionine synthase
what becomes trapped when there is an issue with methionine synthase
folate (5-methyl THF)
in b12 or folate deficiency what cannot be converted into methionine
homocysteine
(B12 def) what happens when folate leaks out of the cell
reduction in intra cellular folate conc
what is the MCV for megaloblastic anemia
around 120 fL
what are the PBS characteristics of megaloblastic anemia (3)
- oval macrocytes
- hyperseg neutrophils
- pancytopenia
describe the retic count in MA and why
decreased because cell division is the problem
why is pancytopenia a symptom in MA
because impaired DNA synthesis effects all cells in the body
which cells rapidly divide
skin, GI, and hematopoietic tissue
describe the hematopoietic tissue in MA
increased cellularity
what impairs DNA synthesis in MA
vitamin B12 or Folate def
what is required for thymidine production
vit B12 and folate
true or False: cells in MA will have an immature nucleus and a mature cytoplasm
T
why is the cytoplasm able to mature normally in MA
RNA function is not affected by Vitamin B12 or folate def
what alimentary tract symptoms do MA have
glossitis and loss of epithelium along GI tract
def? loss of epithelium on tongue results in a smooth surface and soreness
glossitis
vit B12 or folate def? neurological symptoms
vit b12
vit B12 or folate def? develops fasters and why
folate because there is b12 storage in the body
MA because of a folate deficiency has an increased risk of what
cardiovascular disease
t or f: vit b12 is heat liable
F
is it common for someone to be vit b 12 def due to diet
no
what causes pernicious anemia
lack of intrinsic factor causing impaired vit b12 absorption
def? mucosal epithelia cell found in base of gastric pits of stomach that secrete HCl and intrinsic factor
parietal cells
def? epithelia cells that make up the mucosa of the intestine and absorb nutrients and transport them into circulation
enterocytes
def? glycoprotein secreted by parietal cells and is essential for vit b12 absorption
intrinsic factor
def? aka transcobalamin I and is a carrier of salivary protein that protects acid sensitive vit b12 while it moves through the stomach
haptocorrin
def? enzyme that is released by chief cells in the stomach and that degrades food protein into peptides
pepsin
def? digestive enzyme produced by. pancreas that breaks down protein in the small intestine
trypsin
def? energy-using process by which cells absorb molecules by engulfing them
endocytosis
def? lowermost section of the small intestine
terminal ileum
what kind of food has folic acid
leafy green veggies
t or f: folic acid is heat liable
T
t or f: folate def can result from poor diet
T
what % of folate is absorbed from ingestion
50%
what can cause decreased absorption of folate
medicine
how is folate def treated
folic acid supplement
what pts are more at risk of a folate def
dialysis pts
what lab results help with diagnosing MA
high serum bilirubin and high LDH
t or f: in microcytic nonmegaloblastic anemia DNA synthesis is unimpaired
t
what PBS morphology is not seen in microcytic nonmegaloblastic anemia that is seen in MA
hyperseg neutrophils
what is the hb level of a newborn
increased
what disease is a result of macrocytic nonmegaloblastic anemia with round microcytes and target cells
liver disease
anemia? characterized by round microcytes and spur cells
liver disease caused by alcoholism
best lab test for pernicious anemia
detection of ab against IF and serum gastrin level
