Megaloblastic Anaemia

Question 1

Megaloblastic Anaemia results from what

Answer 1

Impairment of DNA synthesis

Question 2

MCV>100fL

Answer 2

True

Question 3

MCH is increased

Answer 3

True

Question 4

MCHC is increased

Answer 4

False. It is the same

Question 5

Sub classification

Answer 5

Megaloblastic

Non-Megaloblastic

Question 6

In non-Megaloblastic Anaemia, MCV<110fL

Answer 6

True

Question 7

Increase in membrane lipid is seen in non-Megaloblastic Anaemia

Answer 7

True

Question 8

Reticulocyte decreases in non-Megaloblastic

Answer 8

False

Question 9

B12 absorption in the distal ileum is assisted by what and what synthesizes it.

Answer 9

Intrinsic factor

Gastric cells

Question 10

Anaemia due to cobalamin deficiency responds to folate diet. T/F

Answer 10

True

Question 11

Increased Vit B12 is seen in

Answer 11

Pregnancy 
Lactation
Puberty
Growth period
Hyperthyroidism 
Disseminated cancer

Question 12

Pernicious Anaemia is caused by

Answer 12

Destruction of gastric cells that produces IF hence malabsorption of VitB12 occurs

Question 13

Folic acid absorption is decreased in

Answer 13

Acidic food substances like legumes, beans

Drugs like phenytoin, oral contraceptives

Celiac disease affecting gut absorption

Heat sensitive

Question 14

Folic acid antagonist

Answer 14

Methotrexate

Question 15

Purine synthesis antagonists

Answer 15

6-mercaptopurine

Question 16

Pyrimidine antagonists

Answer 16

cytosine arabinoside

Question 17

SEQUENCE OF CHANGES IN MEGALOBLASTIC ANEMIA

Answer 17

Vitamin levels decrease
Neutrophil hypersegmentation
Oval macrocytosis in the peripheral blood
Megaloblastic changes in the marrow
Anemia

Question 18

CONSEQUENCE OF MEGALOBLASTIC ANAEMIA

􏰀

Answer 18

Affect all marrow elements.
􏰀 Neurologic symptoms (dorsal columns)
􏰀 Ineffective erythropoiesis: High indirect bilirubin Very high LDH

Question 19

Homocysteinemia is seen in

Answer 19

Vitamin B12 deficiency and folate deficiency

Question 20

High MMA is seen in

Answer 20

Vit B12 deficiency

Question 21

What test helps determine the level at which Vit B12 deficiency is occuring

Answer 21

Schilling’s test

Question 22

Reference values changes in Megaloblastic Anaemia

Answer 22

Pancytopenia- or normal
MCV> 100
MCH- increased
MCHC- Normal
Hematocrit decreases
Haemoglobin concentration decreases
Reticulocytopenia

Question 23

Anisocytosis and poikilocytosis characteristics in Megaloblastic.

What are other characteristics

Answer 23

Anisocytosis- macro ovalocytes(macrocytic normochromic)

Poikilocytosis- tear-drop, schistocytes

Howell jolly bodies(most commonly seen in hyposplenism)
Basophilic stippling(RNA complexes)
Cabot ring

Question 24

In the bone marrow, M:E ratio

Answer 24

Decreases

Question 25

In Megaloblastic Anaemia, the precursors are large

Answer 25

True

Question 26

Biochemical findings

Answer 26

Increase in serum unconjugated Bilirubin

Increase in LDH