Macrocytic Anemia

Question 1

Macrocytic Anemia with Low Retic Count
Megaloblastic Anemia includes?

Answer 1

Vitamin B12 deficiency
Folate deficiency
Drug-induced (DNA synthesis block)

Question 2

Macrocytic Anemia with Low Retic Count
Non-megaloblastic macrocytic anemia includes?

Answer 2

liver disease
hypothyroidism
myelodysplastic syndrome

Question 3

Vitamin B12 Deficiency - Clinical lab effects and treatment
Hematologic effects?

Answer 3

Macrocytic anemia (pancytopenia) with low retic count
Elevated LDH

Question 4

Vitamin B12 Deficiency - Clinical lab effects and treatment
Neurologic

Answer 4

Peripheral neuropathy with paresthesias

Question 5

Vitamin B12 Deficiency - Clinical lab effects and treatment
Psychiatric

Answer 5

Irritability
depression
personality change
memory impairment
dementia
psychosis

Question 6

Vitamin B12 Deficiency - Clinical lab effects and treatment
Treatment

Answer 6

Parenteral vitamin B12 usually recommended (daily x1wk then monthly)
Iron supplementation often needed

Question 7

Pernicious Anemia
Autoimmune d/o associated with what?
Associated with other autoimmune diseases such as?

Answer 7

Anti-intrinsic factor antibodies
thyroid disease; screen every 1-2 yr

Question 8

Pernicious Anemia
Treatment

Answer 8

Parenteral Vitamin B12 usually recommended (daily x1wk then monthly)
Iron supplementation often needed

Question 9

Testing for Vitamin B12 and Folate Deficiency will show what with the following labs In Vitamin B12 deficiency:
Vitamin B12
RBC folate/Serum folate
Methylmalonic acid
Homocysteine

Answer 9

Decreased (<100ng/ml)
normal/normal
increased
increased

Question 10

Testing for Vitamin B12 and Folate Deficiency will show what with the following labs In Folate Deficiency:
Vitamin B12
RBC folate/Serum folate
Methylmalonic acid
Homocysteine

Answer 10

Normal
Decreased/Normal-decreased
Normal
Increased

Question 11

Anemia with High Reticulocyte Count
Clinical Manifestations of long term hemolysis include?

Answer 11

Cholelithiasis
Risk of aplastic crisis (parvovirus B19)
Risk of Pulm HTN

Question 12

Anemia with High Reticulocyte Count
Acute bleeding may have what lab findings as hemolysis?
High retic count may lead to what?
Long-term hemolysis may result in what?

Answer 12

similar
macrocytosis
iron deficiency

Question 13

Anemia with High Reticulocyte Count
Classifications include

Answer 13

Hereditary vs. acquired
Extravascular vs intravascular
Immune vs non-immune