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Blood > Macrocytic anaemia > Flashcards

Macrocytic anaemia Flashcards

1
Q

What are macrocytic anaemias split into?

A

Megaloblastic and Non-megaloblastic

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2
Q

Name 3 causes of megaloblastic anaemia

A

B12 deficiency, folate deficiency, cytotoxic drugs

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3
Q

Name 5 causes of non-megaloblastic anaemia

A

Alcohol, reticulocytosis, liver disease, hypothyroidism, pregnancy

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4
Q

Some causes of macrocytic anaemia do not fit into the Megaloblastic/Non-megaloblastic category, what are they? (4)

A

Myelodysplasia
Myeloma
Myeloproliferative disorders
Aplastic anaemia

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5
Q

What can you see on a blood film in B12/folate deficiency?

A

Hypersegmented polymorphs

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6
Q

What can you see on a blood film in macrocytic anaemia caused by alcohol abuse/liver disease

A

Target cells

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7
Q

What is the most common cause of macrocytic anaemia

A

pernicious anaemia

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8
Q

What blood tests would you run for macrocytic anaemia?

A

LFT (liver disease, alcohol)
TFT
Se B12
Se folate (or red cell folate - gives better picture of long term intake)

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9
Q

If no cause for macrocytic anaemia was found on blood test what investigation would be useful?

A

Bone marrow biopsy

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10
Q

What three items of food are high in folate

A

Green veg
nuts
liver

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11
Q

What three situations could increase the body’s demand of folate?

A

Pregnancy
haemolysis
malignancy

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12
Q

What drugs can cause decreased folate?

A

Alcohol
Phenytoin
Methotrexate

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13
Q

Rx for Folate deficiency?

A

Treat underlying cause

Give B12 - yes, B12 and Folate 5mg/day (but must check B12 level, if its normal and you still give it, can = problems)

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14
Q

What can occur if you give B12 for folate deficiency when the B12 level is normal?

A

Can precipitate Sub-Acute Degeneration of the Cord

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15
Q

Name 3 foods high in B12

A

Meat
fish
dairy

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16
Q

Which population type is at risk on B12 deficiency?

A

Vegans

17
Q

A deficiency in what can cause a decrease in the absorption of B12?

A

Intrinsic factor

18
Q

Features of B12 deficiency are split into general, psych and neuro, what are the 3 general signs?

A

Anaemia
Lemon tinge
Beefy red tongue

19
Q

Features of B12 deficiency are split into general, psych and neuro, what are the 4 neuro signs?

A

Paraesthesia (pins and needles)
Peripheral neuropathy
Optic atrophy
Sub-acute degeneration of the spinal cord

20
Q

What is the test used to investigate pernicious anaemia?

A

Schilling test

21
Q

Treatment of B12 deficiency?

A

Oral cause - Oral B12 (cyanocobalamin)

Malabsorption cause - Parenteral B12 (hydroxocobalamin)

22
Q

Features of B12 deficiency are split into general, psych and neuro, what are the 4 psych signs?

A

Irritability
depression
psychosis
dementia

Blood (7 decks)

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