Macrocytic Anemias

Question 1

Macrocytic Anemias

Answer 1

MCV >100

Question 2

Folic Acid Deficiency

Answer 2

Larger than normal RBC precursors in the bone marrow
Symptoms: fatigue, weakness, pallor, beefy tongue
With dietary deficiency, anemia can be observed within 2-3 months

Question 3

FAD Labs

Answer 3

Decreased WBC, RBC, Hgb, Hct, PLT, Retic
Increased MCV, MCH, RDW, MPV
Normal MCHC

Question 4

FAD Microscopics

Answer 4

Macro-ovalocytes, neutrophil hypersegmentation, Howell-Jolley bodies, basophilic stippling, NRBCs, anisocytosis, large platelets

Question 5

FAD Chemistry

Answer 5

Decreased folate
Increased lactate dehydrogenase, homocysteine, formimino glutamic acid in the urine
Normal MMA

Question 6

Cobalamin Deficiency

Answer 6

AKA vitamin B12
Causes neurological changes
Schillings test: distinguishes pernicious anemia from other causes of B12 deficient anemia

Question 7

CD Labs

Answer 7

Decreased WBC, RBC, Hgb, HCt, PLT, Retic
Increased MCV, MCH, RDW, MPV
Normal MCHC

Question 8

CD Microscopics

Answer 8

Macro-ovalocytes, neutrophil hypersegmentation, Howell-Jolley bodies, basophilic stippling, NRBCS, anisocytosis, large platelets

Question 9

CD Chemistry

Answer 9

Decreased serum cobalamin

Increased lactate dehydrogenase, MMA, homocysteine