Macrocytic anemia

Question 1

What is the impaired component of megaloblastic anemia?

Answer 1

DNA

Question 2

What are the three general causes for megaloblastic anemia?

Answer 2

B12 Deficiency, Folate Deficiency and Drugs that interfere with DNA metabolism

Question 3

What are the megaloblastic changes in BM of RBCs, WBCs and Platelets?

Answer 3

RBCs, Large and asynchronous maturation
WBCs, Giant forms (metas/Bands) asynchronous maturation
Platelets = Giant platelets

Question 4

What are the megaloblastic changes in PB of RBCs, WBCs and Platelets?

Answer 4

RBC= Oval macrocytes, teardrops, H-J, Cabot rings,
WBC = WBCs, Giant forms (metas/Bands)  also Have HYPERsegs (>5 lobes
Platelets = Giant

Question 5

What are the reasons for Cabot rings in megaloblastic anemia?

Answer 5

Ineffective hematopoiesis

Question 6

What are the reasons DECREASED retic count in megaloblastic anemia?

Answer 6

Ineffective hematopoiesis

Question 7

What are the reasons for H-J bodies in megaloblastic anemia?

Answer 7

Ineffective hematopoiesis

Question 8

What are the reasons for hyperplastic BM and panocytopenic PB and in megaloblastic anemia?

Answer 8

Ineffective hematopoiesis

Question 9

What are the reasons for hyper segmented neutrophils in megaloblastic anemia?

Answer 9

Ineffective hematopoiesis

Question 10

What is the reason for increased MCV in megaloblastic anemia?

Answer 10

Fewer cell divisions

Question 11

What is the reason for macroovalacytes in megaloblastic anemia?

Answer 11

Fewer cell divisions and asynchronous maturation

Question 12

what is the reason for teardrop cells in megaloblastic anemia?

Answer 12

Crowding effect

Question 13

What are the expected results for serum bilirubin in megaloblastic anemia?

Answer 13

Increased

Question 14

What are the expected results for serum LDH in megaloblastic anemia?

Answer 14

Increased

Question 15

What are the expected results for serum iron in megaloblastic anemia?

Answer 15

Increased

Question 16

What is the function of intrinsic factor (IF) in B12 absorption?

Answer 16

Binds to it t for absorption

Question 17

Where is the site of IF production?

Answer 17

Parietal cells of stomach

Question 18

Where is the site of absorption of B12?

Answer 18

Ileum

Question 19

Where is the site of storage for B12?

Answer 19

Liver

Question 20

What are the clinical features of B12 deficiency?

Answer 20

Sore tongue (beefy red) and jaundice

Question 21

What symptom is mostly unique to B12?

Answer 21

Neurological problems

Question 22

What is the most common cause of B12 deficiency?

Answer 22

Impaired absorption

Question 23

What is the defect in pernicious anemia which leased to impaired B12 absorption?

Answer 23

Inability of Mucosa to secrete IF

Question 24

What does D. Latum or increased Bacteria flora cause B12 deficiency?

Answer 24

Competition

Question 25

Where is the site of absorption of Folate?

Answer 25

Jejunum

Question 26

What is the length of storage for folate?

Answer 26

4-5 months

Question 27

What is the most common reason for flip acid deficiency?

Answer 27

Poor diet

Question 28

What are the four reasons for increased folic acid?

Answer 28

Accelerate hematopoiesis
Pregnancy
Growth
Pregnancy

Question 29

What are the three drugs that interfere with folate absorption?

Answer 29

Birth control, anti-TB drugs, dilantin and AZT

Question 30

What RBC morphology do you expect with non-megaloblastic anemia?

Answer 30

round macrocytes, targets, stomatocytes and spur cells

Question 31

What are the two causes for non-megaloblastic anemia?

Answer 31

Reticulocytosis, liver disease/alcoholism

Question 32

What is the reason for targets in PB of a patient with Liver disease?

Answer 32

??????