Macrocytic Anemias

Question 1

Megaoblastic Anemia is:

Answer 1

a deficiency in vitamin B12 and/or folic acid

Question 2

Vitamin B12 is:

Answer 2

found in diet and has long term storage capacity

Question 3

Daily intake and requirements for B12

Answer 3

The minimum requirement is 2ug/day
The average consumption is 5-30ug/day
1-2mg is stored in liver

Question 4

Asynchronous maturation of red blood cell precursors happens when:

Answer 4

It appears as though the nucleus and the cytoplasm are at different maturation stages. The nuclear and cytoplasmic ages do not correspond.

Question 5

Ineffective Erythropoiesis occurs when:

Answer 5

Myeloid:erythroid ratio is 1:1 to 1:3.

Question 6

During a CBC with RBC maturation:

Answer 6

RDW is increased

Question 7

During a peripheral smear with RBC maturation:

Answer 7

RBCs will occur to be Macro-ovalocytes. Indicator of megaloblastic anemias.

Question 8

During a peripheral smear with RBC maturation, WBCs will appear:

Answer 8

hypersegmented neutrophils (=> 6 lobes)
indicator of megaloblastic anemias

Question 9

Symptoms of megaloblastic anemia includes:

Answer 9

light headedness, extreme weakness, and neurological symptoms may occur

Question 10

Pernicious anemia occurs when:

Answer 10

There is lack of intrinsic factor which is significant in the absorption of vitamin B12

Question 11

Laboratory tests used in diagnosing megaloblastic anemia are:

Answer 11

Serum Methylmalonic Acid and Homocysteine. They are elevated when vitamin B12 are deficient.

Question 12

Megaloblastic features

Answer 12

macrocytes are large and oval
MCHC is normal

Question 13

Non-megaloblastic features

Answer 13

macrocytes are round and hypochromic
MCHC is low

Question 14

Non-megaloblastic round hypochromic macrocytes are caused by:

Answer 14

Alcoholism
Hypothyroidism
Liver Disease
Chemo treatment
Myelodysplastic syndromes