macrocytic anaemia Flashcards
what can macrocytic anaemia be divided into?
megablastic and non-megablastic anaemia
what are the causes of megablastic
folate deficiency
b12 deficiency –» PA
non megablastic anaemia causes
alcohol liver disease pregnancy hypothyroidism reticulyosis
what is megablastic anaemia
abnormal erythryblastic with delayed nuclear maturation and resulting in impaired dna synthesis
large immature nuclei present
who is pernicious anaemia deficiency seen in
females blue hair and fair skin 60s plus blood group A increased risk or associated wth gastric carcinoma seen with other AI
what can b12 def cause
degeneration of the spinal cord
dementia
delirum
diarrhoea
what is pernicious anaemia and its cause
loss of intrinsic factor through autoimmune attack on parietal cells
therefore lack of b12 absorption in the ileum
causes include gastrocomy and ileal resection removal being vegan
tapework and topical sprue
gastritis
test
schilling or b12 blood test - antibodies to IF blood film CV increased bilirubin reducted WCC, plaetele, b12, hb
presentation
angular stomatitis
neurological signs
parasthestia and weakness
management
hdroyxbcolbaltamn 2mg daily
folate defiency what is it
old age , neonates
similar causes to Iron deficiency
other causes
haemdyadlsis
anti-convulsants -phenytoin, trimethorprim (anti folate), methotrexate
ix
reduced folate on bloods, jejeal biopsy (rarely)
managex
folic acid
400mg or 5mg daily
pregnancy prophylaxis
