RBC disorder pt 2 Flashcards
Macrocytic Anemias
what are 2 types of macrocytic anemias?
- Megaloblastic anemia
- Macrocytic anemia
Megaloblastic anemia
what leads to megaloblastic anemia?
why does it happen?
what are 2 types of megaloblastic anemia?
what is another name for the large erythroid cells found in this type of anemia?
vit B12 deficiency or folic acid deficiency
impaired DNA synthesis leading to ineffective hematopoiesis
- pernicious anemia
- folate deficiency
giant metamyelocytes
Megaloblastic Anemia
why do folate and B-12 vitamins lead to megaloblastic anemia?
where do we get Vit B-12?
who is at risk of developing megaloblastic anemia due to vit b12 deficiency?
how long does it take for megaloblastic anemia develops due to vit b12 deficiency?
how do we absorb vit b12?
what is used to transport vit b12 in the ileum?
where is vit b12 stored mainly?
both lead to the conversion of homocysteine to methionine in DNA synthesis
from animal meat, or eggs, cheese
vegetarians
years
in ileum using intrinsic factor
transcobalamin 2
liver
Pernicious Anemia
what is characteristic?
what is it?
what can cause it?
what are 3 antibodies against Intrinsic factor?
most common cause of vit b12 deficiency
anti-bodies against intrinsic factor
atrophic gastritis (immune) and achloridia (reduced gastric acid)
Type I = blocks binding site
Type II = blocks binding site of IF-B12 to ileal receptor
Type III = made agains alpha and beta subunits of gastric proton pump
Megaloblastic Anemia Labs for all (common)
Hb?
peripheral blood smear: RBC? WBC?
MCV?
Bone marrow?
cytoplasm?
granulocytic series?
platelets?
Hb = reduced
RBC = macrocytic and precense Howell-Jolly bodies
WBC = hypersegmented neutrophils
MCV = more than 100
Bone Marrow = increased cellularity and no chromatin clumping
cytoplasm = regular hemoglobinization
granylocytic series = giant metamyelocytes
platelets = abnormal large with multilobation of nuclei
what is this?
megaloblastic anemia
what is this?
what is arrow pointing at?
megaloblastic anemia
howell-jolly body
what is this?
megaloblastic anemia
what is this?
megaloblastic anemia
what is this?
megaloblastic anemia
what is this?
megaloblastic anemia
(note nucleus looks like a lace)
what is this?
megaloblastic anemia
Megaloblastic anemia labs for B12 Deficiency
serum bilirubin?
serum cobalamin?
serum homocysteine?
methylmalonic acid?
antibodies to IF?
Schiling test?
Urine?
serum bilirubin = mild increase
serum cobalamin = decreased
serum homocysteine = increased
methylmalonic acid = increased
antibodies to IF =present
Urine = increased methylmalonic acid
Megaloblastic Anemia clinical features (common)
What clinical features will you find in all megaloblastic anemia?
anemia
mild icterus
glossitis (loss of papillae)
Megaloblastic Anemia clinical features (Pernicious anemia)
what clinical features will you find in pernicious anemia?
This can increase the risk for what?
autoimmune gastritis (atrophy of fundic glands and intestinal metaplasia)
cancer
