Macrocytic Anaemia Flashcards
What issues can cause malabsorption?
Lack of intrinsic factor in the stomach, terminal ileum problems
What is pernicious anaemia?
An autoimmune condition where atrophic gastritis leads to a lack of IF secretion from parietal cells and therefore dietary B12 remains unbound and cannot be absorbed
How does a B12 deficiency cause anaemia?
B12 is needed to synthesise thymidine and therefore DNA. This leads to slow RBC production
What investigations would you do for pernicious anaemia?
Parietal cell antibodies, IF antibodies
What can cause macrocytic anaemia?
B12/folate deficiency, excess alcohol/liver disease, hypothyroidism, bone marrow failure
What are signs specific to pernicious anaemia?
Angular stomatitis, lemon-yellow skin, neurological features
How would you treat macrocytic anaemia caused by diet?
Oral B12
How would you treat folic acid deficiency?
Folic acid tablets daily for 4 months
How would you treat pernicious anaemia?
B12 injections, oral B12
What is a sign of macrocytic anaemia caused by hypothydoisism?
Reduced reflexes
