Macrocytic Anemias Flashcards by Liz Haywood

Q

Cellular component impaired in megaloblastic anemia

A

Impaired DNA synthesis affecting all dividing cells of the body

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Q

3 general causes for impaired cellular component in megaloblastic anemia

A

Vitamin B12 deficiency
Folate deficiency
Drugs interfering DNA metabolism

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Q

Typical megaloblastic changes in RBC precursors in BM

A

Megaloblasts

- Asynchronous maturation

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Q

Typical megaloblastic changes in WBC precursors in BM

A

Giant forms

- Asynchronous development

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Q

Typical megaloblastic changes in PLT precursors in BM

A

Abnormal, not distinctive

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Q

Typical megaloblastic changes in RBC precursors in PB

A

Oval macrocytes
Tear drops
Howell-Jolly bodies
Cabot rings

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Q

Typical megaloblastic changes in WBC precursors in PB

A

Giant forms

- Hypersegmented neutrophils

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Q

Typical megaloblastic changes in PLT precursors in PB

A

May see giant platelets

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Q

Correlate BM findings in megaloblastic anemia w/ PB

- Cabot ring

A

Ineffective HP

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Q

Correlate BM findings in megaloblastic anemia w/ PB

- ↓ retic count

A

↑ ineffective HP

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Q

Correlate BM findings in megaloblastic anemia w/ PB

- Howell-Jolly bodies

A

↑ mitotic forms

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Q

Correlate BM findings in megaloblastic anemia w/ PB

- Hyperplastic BM → pancytopenic PB

A

Ineffective HP

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Q

Correlate BM findings in megaloblastic anemia w/ PB

- Hypersegmented neutrophils

A

↑ mitotic divisions of nucleus

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Q

Correlate BM findings in megaloblastic anemia w/ PB

- ↑ MCV

A

Delayed cell divisions

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Q

Correlate BM findings in megaloblastic anemia w/ PB

- Macroovalocytes

A

Delayed cell divisions and asynchronous maturation

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Q

Correlate BM findings in megaloblastic anemia w/ PB

- Teardrop cells

A

Crowding

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Q

Expected results in megaloblastic anemia

- Serum bilirubin

A

Increased

Q

Expected results in megaloblastic anemia

- Serum LDH

A

Increased

Q

Expected results in megaloblastic anemia

- Serum iron

A

Increased

Q

Function of intrinsic factor in vitamin B12 absorption

A

To absorb B12

Q

Site of intrinsic factor production in vitamin B12 absorption

A

Secreted by parietal cells of stomach

Q

Site of vitamin B12 absorption

A

Ileum

Q

Storage organ for vitamin B12

A

Liver

Q

Extent of body stores for vitamin B12

A

4-5 years

Clinical features vitamin B12 and/or folate share

- Sore tongue ("beefy red") | - Lemon-yellow skin...jaundice

Megaloblastic anemia unique to neurological problems

Vitamin B12

Most common cause of vitamin B12 deficiency

Impaired absorption

Defect in pernicious anemia leading to impaired vitamin B12 absorption

Inability of gastric mucosa to secrete IF

How does D. latum or increased bacterial flora in GI tract cause a vitamin B12 deficiency?

Competes w/ use for vitamin B12

Site of absorption of folate metabolism

Jejunum

Extend of body stores for folate metabolism

4-5 months

Most common cause of folic acid deficiency

Poor diet

4 causes of increased requirement of folic acid

- Accelerated HP (hemolytic anemia) - Neoplastic disease - Growth - Pregnancy

3 drugs that interfere w/ absorption of folate

- Folate antagonists (chemotherapy) - Birth control - Anti-TB drugs (dilentin, AZT)

RBC morphology expected to see in a patient w/ non-megaloblastic anemia

- Round macrocytes | - Targets, stomatocytes, spur cells

2 causes of non-megaloblastic anemia

- Liver disease and/or alcoholism | - Reticulocytosis

Physiological reason for presence of target cells in PB of a patient w/ liver disease

?

Asynchronous maturation

?

Intrinsic factor

?

Transcobalamin II

?