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Hematology 2 Lec > MACROCYTIC NORMOCHROMIC ANEMIA > Flashcards

MACROCYTIC NORMOCHROMIC ANEMIA Flashcards

1
Q

AA

-Characterized by enlargement of all rapidly proliferating cells of the body including

A

marrow cells

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2
Q

-Abnormality:

A

Nuclear cytoplasmic asynchrony (maturation arrest).

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3
Q

Cytoplasm development is

A

normal

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4
Q

-Most common causes:

A

Vitamin B12 deficiency
Folate deficiency

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5
Q

1) MEGALOBLASTIC ANEMIA Laboratory Findings:

A

-macroovalocytes
-hypersegmented neutrophils
-basophilic stippling, multiple Howell jolly bodies
-nucleated RBC’s with karyorrheexis
-Pancytopenia, leucopenia and thrombocytopenia
-Increased serum lactate dehydrogenase
-Increased serum muramidase -Increased endogenous CO

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6
Q

-required in the demethylation of folate during DNA synthesis Reaction that involves Vit B12

A

Vitamin B12

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7
Q

*Isomerization of methylmalonyl CoA to succinyl CoA

A

Vitamin B12

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8
Q

causes high level of serum of methylmalonic acid (MMA) and its level is diagnostic

A

Vitamin B12

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9
Q

*Serves as a coenzyme (methylcobalamin form) in generation of Tetrahydrofuran (THF)

A

Vitamin B12

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10
Q

-is absorbed through the ileum with the aid of the intrinsic factor (IF) produced by parietal cells transported by transcobalamin (TC II) in the plasma

A

Folate

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11
Q

*The function is to transfer carbon units in the form of methyl groups from donors to receptors during metabolism of amino acid and nucleotides.

A

Folate

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12
Q
  • Deficiency leads to impaired cell replication.
A

Folate

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13
Q

Related Causes of Vitamin B12 Deficiency
1.Inadequate intake
2.Impaired absorption
3. Malabsorption Syndrome
4. Lack of availability of Cobalamin

A
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14
Q

Celiac and Ileal disease (Crohn’s disease/ regional enteritis)

A
  1. Malabsorption Syndrome
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15
Q

tropical sprue, resection of small bowel

A
  1. Malabsorption Syndrome
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16
Q

: deficiency of IF-B1 receptors

A

Imerslund-Grasbeck syndrome

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17
Q

: gastric hypersecretion

A

Zollinger-Ellison syndrome

18
Q

Blind loop syndrome

A
  1. Lack of availability of Cobalamin
19
Q

Infection with Diphyllobothrium latum

A
  1. Lack of availability of Cobalamin
20
Q

Inability of gastric mucosa to secrete intrinsic factor resulting to Pernicious anemia.

A

-Decrease/Deficiency of Vit B12

21
Q

also causes this deficiency

A

-Neomycin and Ethanol

22
Q

May also be due to abnormal production of TC II.

A

-Neomycin and Ethanol

23
Q

-Autoimmune type of Vit B12 deficiency anemia

A

**PERNICIOUS ANEMIA

24
Q

**PERNICIOUS ANEMIA Autoantibodies involved:

A
  1. Anti-parietal cell antibodies
  2. Anti-intrinsic factor antibodies
  3. Pathologic CD4 T cells
25
Q

Anti-intrinsic factor antibodies Types:

A

Blocking antibody
Binding antibody

26
Q

: blocks the binding of cobalamin to IF

A

Blocking antibody

27
Q

: binds to the cobalamin IF complex and prevents the complex rom binding to receptors in the ileum.

A

Binding antibody

28
Q
  • inappropriately recognize and initiate an autoimmune response resulting to chronic inflammatory infiltration follows, which extends into the wall of the stomach.
A

Pathologic CD4 T cells

29
Q

PERNICIOUS ANEMIA S/S:

A

-atrophic glossitis and atrophic gastritis
-Achloridria
-Episodic abdominal pain, constipation and diarrhea
-anemia w/ combination of skin pallor and lemon yellow skin
-Diffuse and irregular degeneration of CNS white matter

30
Q

*sensation of pins and needles in distal extremities

A

-Diffuse and irregular degeneration of CNS white matter

31
Q

*emotional instability and change of personality

A

-Diffuse and irregular degeneration of CNS white matter

32
Q

Diagnosis of Vitamin B12 Deficiency

A
  1. Serum Cobalamin Assay
  2. Methylmalonic acid and Homocysteine Assay -
  3. Deoxyuridine Supression Test
  4. Schilling Test
  5. Competitive Protein Binding Radioassay
  6. Other tests: Fecalysis (bothriocephalus anemia)
33
Q
  • Microbiological assay
A
  1. Serum Cobalamin Assay
34
Q

uses E. gracilis (requires Vit B12 for growth) to test the level of B12 in the serum of patients.

A
  1. Serum Cobalamin Assay
35
Q
  1. Serum Cobalamin Assay NV.
A

200-900 mg/dL

36
Q

-Deficiency of B12 will lead to excretion of increased amount of methylmalonate in urine

A
  1. Methylmalonic acid and Homocysteine Assay
37
Q

–measures ability of the BM to utilize deoxyuridine in DNA synthesis

A
  1. Deoxyuridine Supression Test
38
Q
  • Measures the body’s ability to secrete viable IF and absorb orally administered Co-labeled B12
A
  1. Schilling Test
39
Q
  • Method of choice for B12 and folate deficiency quantitation
A
  1. Competitive Protein Binding Radioassay
40
Q
  1. Other tests
A

Fecalysis (bothriocephalus anemia)

41
Q

-abnormal in both cobalamin and folate deficiency

A

Deoxyuridine Supression Test

Hematology 2 Lec (29 decks)

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