Megaloblastic Flashcards

1
Q

Who is most at risk for folate deficiency

A

elderly, poor, alcoholics, preganant women.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Labs for folate deficiency

A

Serum folate levels and homocysteine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What types of birth defects can a lack of folate cause

A

Spina Bifida and other neural tube defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What do you look for on a smear

A

HYPERSEGMENTED NEUTROPHILS. HYPERSEGMENTED polys are always associated with megaloblastic anemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where is B12 absorbed

A

distal illeum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does B12 disorder cause that folate does not

A

neurological problems (lack of sensory awareness in the dark, paresthesia,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is pernicious anemia

A

gastric atrophy, loss of IF due to CD4+ recognition of ATPase, Anti-IF Ab, or anti-parietal cell antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where is most iron in the body found?

A

Bound to hemoglobin, then storage, then myoglobin, then labile, then transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

1 ml of blood = 1 mg of iron

A

….

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the smallest pool of iron?

A

transferin (transport iron)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Heme iron is absorbed where

A

proximal duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is Iron transferred through the body

A

ferritin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What lets iron gastric epithelia

A

Ferriportin…this is regulated by hepcidin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is hepcidin

A

negative regulator of iron….as levels go up, they degrade ferriportin so that more iron can’t be absorbed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

WHat is important about ascorbic acid and gastric acid

A

They increase the absorption of non-heme iron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ferriportin:

A

Cellular transport of iron into the plasma

17
Q

Hipcidin

A

negative regulator of iron uptake

18
Q

Facators outside the GI tract that increase iron absorption

A

Hypoxia, anemia, depletion of iron stores, increased rbc production (erythropoiesis)

19
Q

Iron deficiency causes

A

GI surgery, non-tropical sprue (celiac), Picca

20
Q

Bilroth surgery>

A

Could cut out the proximal duodenum where iron is absorbed so that the pt then could not absor iron anymore.

21
Q

Other complications of bilroth

A

sutures could bleed, Blind loop (causes B 12 deficiency when its overgrown by bacteria)

22
Q

Non -tropical sprue

A

Celiac, allerfic to gluten. Gluten induced damage to epithelial cells

23
Q

Tropical sprue?

A

overgrpowth of coliform in jejunum, results in malabsorption of folate, B12, fat…

24
Q

PICCA?

A

Eat iron chelators

25
GI bleeds are most common?
Peptic ulcer disease, hiatal hernia, chronic gastritis, hemorrhoids, GI surgery, neoplasm
26
GI bleeds to look out for in kids
milk allergy, meckels diverticulitis
27
Menstrual cycle abnormalities?
Longer than a week, more than one box of tampons, clots, interfere with daily activities
28
Hookworm causes what type of deficiency?
Iron
29
Tapeworm
B12
30
Does TIBC go up or down in iron deficiency?
Goes up
31
What about hepcidin in iron deficiency?
Goes way down
32
What is anemia of chronic disease?
You don't want bacteria to have access to iron stores, so the body hides tron stores and decreases iron uptake (hepcidin levels go up).