pernicious anaemia

Question 1

key causes of low B12

Answer 1

pernicious anaemia
insufficient dietary B12
medications (PPI and metformin)

Question 2

what is pernicious anaemia

Answer 2

autoimmune condition involving antibodies against the parietal cells or intrinsic factor resulting in a lack of vitamin B12 absorbed

Question 3

where is vitamin B12 absorbed

Answer 3

distal ileum

Question 4

neurological symptoms of B12 deficiency

Answer 4

peripheral neuropathy
loss of vibration sense
loss of proprioception
visual changes
mood and cognitive changes

Question 5

what autoantibodies are used to diagnose pernicious anaemia

Answer 5

intrinsic factor antibodies
gastric parietal cell antibodies

Question 6

management of pernicious anaemia

Answer 6

IM hydroxocobalamin
- no neuro symptoms: 3 times a week for 2 weeks
- neuro symptoms: alternate days until no further improvement
maintenance:
- 2-3 monthly injections for life

Question 7

what happens if you treat folate deficiency before B12 deficiency

Answer 7

subacute combined degeneration of the cord