Macrocytic Anemia Lecture Powerpoint

Question 1

Macrocytic anemias are typically what type of anemias?

Answer 1

….B12 and folate deficiency anemias

Question 2

B12 and folate deficiency is mostly seen in….

Answer 2

….elderly patients who consume excessive alcohol causing atrophic gastritis

Question 3

B12 requires ___ to be maximally absorbed in the ____

Answer 3

intrinsic factor, terminal ileum

Question 4

Macrocytosis

Answer 4

Presence of MCV level >100 femoliters

Question 5

A large source of iron and B vitamins

Answer 5

Red meat

Question 6

Hypersegmented neutrophil definition and what causes it?

Answer 6

A neutrophil with more than 5 nuclear segments or lobes, often seen in B12 or folate deficiencies

Question 7

Medications that interfere with DNA synthesis causing macrocytic anemia

Answer 7

• phenobarbital
• oral conraceptives
• chemotherapeutic agents

Question 8

Hypothyroidism/alcoholism/ can cause…

Answer 8

…Megaloblastic anemia

Question 9

3 false alarms for macrocytic anemia

Answer 9

1) cold agglutinins
2) hyperglycemia
3) leukocytosis

Question 10

Target cells presence indicates…

Answer 10

….Liver disease

Question 11

Patient with iron deficiency anemia is placed on ferrous sulfate. How do you tell if therapy is working within the 1st week as opposed to waiting for cell turnover after 120 days?

Answer 11

-Check reticulocyte count

Question 12

Pernicious anemia

Answer 12

An autoimmune form of megaloblastic anemia in which antibodies against intrinsic factor are developed preventing DNA production

Question 13

The schilling test

Answer 13

Old test method used to evaluate patient with suspected pernicious anemia via radiolabeled B12 no longer used

Question 14

3 new work arounds for B12 absorption independent of intrinsic factor and which is the best?

Answer 14

1) nasal spray
2) subcutaneous injection (preferred)
3) B12 high dosing can override the need for intrinsic factor and allow absorption

Question 15

Swollen or sore tongue can be a sign of….

Answer 15

…B12 deficiency

Question 16

B12 deficiency causes ___ symptoms, and the ___ is affected first affecting ___ and ____. If it takes too long to begin treatment, it can cause….

Answer 16

neurological, posterior column, proprioception and vibratory sensation

Irreversible damage

Question 17

Plummer vinson syndrome definition

Answer 17

Presence of esophageal webs due to iron deficient anemia

Question 18

Folate deficiency vs B12 deficiency timeline

Answer 18

Months, almost a year

Question 19

Methotrexate can cause ___ deficiency

Answer 19

Folic acid

Question 20

Folate deficiency does not cause…

Answer 20

Neurological symptoms