Lecture 10 Chapter 18 Flashcards
What characteristics have a low reticulocyte and high/increased MCV
Megaloblastic/macrocytic
Macrocytic anemias effect
Production of DNA
What is the first step when examining a blood smear
Look at reticulocytes and MCV
What happens if you cannot synthesize thymine
Cannot produce thymidine → cannot make DNA → cells grow extra because they want to divide but cannot without enough thymidine
What WBC commonly cannot divide due to lack of thymidine
Hypersegmented neutrophil
What is a common cause of macrocytic anemias
Vitamin deficiency of b-12 and folic acid
Hypersegmented neutrophil
What do you do if you are uncertain if a segmented neutrophil is hypersegmented
Do not report it unless certain
Symptoms/signs of megaloblastic anemia
Hypersegmented neutrophil
Ovalocytes
Decreased MCH
MCV may be 120
MCHC normal
Where are vitamins stored in your body
Liver
How much folate do you normally have stored
About enough for 1 week
How long is b-12 stored for
About 1 year
What food has the highest source of folate
Vegetables
What is the only source of b-12
Animal products, red meat, meat
Why must a pregnant woman take folate supplements
Folic acid deficiency in a pregnant woman will severely effect the fetus. Prevents the spinal cord from closing, most likely paralyzing the child
What disease do you have it you cannot absorb b-12 but have plenty of it
Pernicious anemia
What happens right after you absorb folate acid
It gets methylated
Where does methyl-b12 come from
Folate acid
H4-folate produces
Thymidine which allows for DNA synthesis
What is the difference between homocysteine and methionine
Methionine has a methyl group
Where does methionine get its methyl group
Methyl - b12
What happens if you are deficient of b12
Homocysteine adds up/increases
Increase can cause cardiovascular disease
Methylmalonyl-coa adds up and can become methylmatonic acid
Cannot make DNA and RNA
If you have microcytic anemia and your MMA (methylmalonic acid) increases, what is your conclusion
B12 deficiency
Increased homocysteine
What is acetyl choline
A neurotransmitter in the brain
What can cause folate deficiency
Lifestyle stressors
Standard American diet
Aging
Folate deficiency causes what
Neural tube defects
Infertility (sperm)
Reduced methylation
For b-12 deficiency what is the:
MCV
Smear
Pernicious anemia?
Homocystine
Methylmalonic acid
> 100
Macrocytosis with hypersegmented neutrophils
Yes
Elevated
Elevated
For folate deficiency what is the:
MCV
Smear
Pernicious anemia?
Homocystine
Methylmalonic acid
> 100
Macrocytosis with hypersegmented neutrophils
No
Elevated
Normal
What is pernicious anemia
B-12 goes into stomach → binds within intrinsic factor → travels to intestines → gets absorbed in the ileum
What happens if b-12 does not bind to an intrinsic factor
It does not get absorbed in the ileum and travels through the feces
What type of disease is pernicious anemia
Autoimmune
It attacks the intrinsic factor and parietal cells
What does gastric analysis look at
Acidity of stomach
B-12 must be able to break off from food to bind with intrinsic factor
What does your smear have to have to be megaloblastic
Hypersegmented neutrophils
Ovalocytes
