Macrocytic Anaemia

Question 1

Source of Vitamin B12

Answer 1

Meat and Dairy

Large Body Stores

Question 2

Causes of Vitamin B12 Deficiency

Answer 2

Dietary
Malabsorption - Stomach: Intrinsic Factor deficiency
- Terminal Ileum

Question 3

Symptoms of Vitamin B12 Deficiency

Answer 3

Mouth: Glossitis, Angular Cheilosis
Neuropsychiatric - Irritability, depression, psychosis, dementia
Neuroligical - Paraesthesiae, Peripheral Neuropathy

Question 4

Autoimmune atrophic gastritis

Answer 4

Pernicious Anaemia - achlorhydria and lack of Intrinsic Factor
Most common cause of macrocytic anaemia in West

Question 5

Tests for Pernicious Anaemia

Answer 5

Parietal cell antibodies (90%)
Intrinsic Factor antibodies (50%)
Schilling Test (outdated)

Question 6

Source of Folate

Answer 6

Green Vegetables
Nuts
Yeast
Liver
Synthesized by gut bacteria

Question 7

Cause of Folate Deficiency

Answer 7

Poor Diet
Increased Demand - Pregnancy of high cell turnover
Malabsorption - Coeliac Disease, tropical sprue
Drugs - Alcohol, anti-epileptics, methotrexate, trimethoprim