Megaloblastic Anemia

Question 1

Types of megaloblastic anemia?

Answer 1

1- Vitamin B12 anemia

2- Folate deficiency anemia

Question 2

What is vitamin B12 deficiency anemia?

Answer 2

Deficiency of vitamin b12 in human body

Question 3

What is the other name of Vitamin B12?

Answer 3

Cobalamin

Question 4

Source of vitamin B12?

Answer 4

1- Non veg

2- Milk

Question 5

Who are at higher risk of vitamin B12 deficiency?

Answer 5

Vegan people bcz they neither eat Meat or Drink milk

Question 6

B12 Metabolism?

Answer 6

Vitamin B12 bind R-Binder in saliva—> B12-R complex(helpful in surviving in acidic env.)—> Goes into SI where cleave with pancreatic enzymes—> Bind with IF(helpful in transportation across intestinal mucosa)

Question 7

Where Vit B12 absorbs?

Answer 7

Terminal ileum

Question 8

Etiology of Vitamin B12?

Answer 8

1- Dietary intake(vegan people)
2- Decrease absorption(Gastrectomy and pernicious anemia)
3- Decrease pancreatic enzymes
4- Bacterial overgrowth(consumes vit B12)
5- Increase B12 requirements( pregnancy, lactation, Fish tape worm)

Question 9

Treatment of B12 deficiency?

Answer 9

Hydroxycobalamine 1000ug i.m five dose in 2-3days
Maintenance therapy 1000ug/3mo for life
Patient may need additional iron therapy
Sensory neuropathy takes 6-12 mo

Question 10

Diagnosis of VitB12 deficiency ?

Answer 10

Macrocytic anemia, MCV >110
Megaloblastic blood smear (macro-ovalocytes
and hypersegmented neutrophils)
Low serum vitamin B12 level
Pancytopenia, decrease Hb

elevated level of serum methylmalonic acid (greater than 1000 nmol/L) or homocysteine.

Anisocytosis and poikilocytosis
Ferritin level elevated

Question 11

Treatment of Folate deficiency?

Answer 11

Oral folic acid 5 mg daily for 3 weeks will treat acute deficiency
5 mg once weekly is adequate mainte­nance therapy.

Prophylactic folic acid in pregnancy pre­vents megaloblastosis in women at risk, and reduces the risk of fetal neural tube defects

Prophylactic supplementation is also given in chronic haematological disease associated with reduced red cell lifespan (e.g. haemolytic anaemias).

Question 12

Diagnosis of folio acid deficiency ?

Answer 12

Diagnostic findings
• Serum folate levels may be low but are difficult to interpret
• Low red cell folate levels indicate prolonged folate deficiency
and are probably the most relevant measure

Corroborative findings
• Macrocytic dysplastic blood picture
• Megaloblastic marrow