Macrocytic Anemia

Question 1

This group of anemias get their name from the presence of abnormally large RBC precursor cells in the bone marrow

Answer 1

Megaloblastic anemias

Question 2

Underlying problem in megaloblastic anemia is deficiency of ….

Answer 2

vitamin B12 and/or folic acid (both of which are necessary for normal DNA synthesis by erythrocyte precursors in the bone marrow)

Question 3

B12 deficiency interferes with ___________ of nerves so __________ symptoms can be seen

Answer 3

1) mylination

2) neurologic

Question 4

Most common case of B12 deficiency

Answer 4

pernicious anemia

Question 5

T/F: Lack of B12 in diet is a usual explanation for megaloblastic anemia

Answer 5

FALSE: B12 is stored in the liver for 3-6 years. Only strict vegetarians are at risk for dietary B12 deficiency

Question 6

Most common underlying cause of folic acid deficiency in the US is

Answer 6

alcoholism

Question 7

T/F: Folic acid deficiency does not produce neurological symptoms

Answer 7

True

Question 8

Most reliable way to differentiate between the two major causes of megaloblastic anemia

Answer 8

Measuring serum levels of B12 and folate

Question 9

B12 deficiency is associated with an elevation of both _____ and ______. Whereas, folate deficiency is associated with an elevated _____ but _____ is normal.

Answer 9

1) MMA (serum methymalonc)
2) HC (homocysteine)
3) HC
4) MMA

Question 10

If diagnosis proves to be pernicious anemia, patients are treated with…

Answer 10

IM B12

Question 11

Treatment of folic acid deficiency

Answer 11

1) Oral folic acid (1-5mg/day for 1-4 months)

2) Alcoholics should be advised to stop drinking

Question 12

Other causes of macrocytosis (other than megaloblastic)

Answer 12

Hypothyrodism, liver disease, alcoholism, recent hemolysis, hematologic malignancies, some drugs (AZT, dilatin, methotrexate, azathoprine)