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MCD Y2: Haematology > Vit B12 and folic acid deficiency > Flashcards

Vit B12 and folic acid deficiency Flashcards

1
Q

What is the alternative name for vit B12?

A

Cobalamin

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2
Q

What is the role of VitB12?

A

DNA synthesis

Maintaining nervous system integrity

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3
Q

What is the main dietary source of folic acid?

A

Leafy greens

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4
Q

What is the role of folic acid in haematopiesis?

A

DNA synthesis

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5
Q

What is the role of folic acid in biochemical pathways in the body?

A

Homocysteine metabolism to methionine

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6
Q

What is the main consequence of defective homocysteine metabolism?

A

CVD

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7
Q

What roles do vit B12 and folic acid play in DNA synthesis?

A

dMTP synthesis:

B12 acts as a cofactor for methionine synthetase

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8
Q

Recall some dietary sources of B12

A

Meat, salmon, cod, dairy products, eggs

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9
Q

Recall the full pathway of B12 absorption

A

In stomach binds to transcobalamin 1
Gastric parietal cells produce IF
B12 displaced from transcobalamin 1 in intestine
B12 binds IF –> terminal ileum
B12-IF complex binds receptor –> circulation
In circulation B12 binds transcobalamin 2

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10
Q

Recall the full pathway of folic acid absorption

A

Hydrolysed in stomach due to low pH –> monoglutamates

Absorbed as pteroglutamates

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11
Q

Recall 3 causes of B12 deficiency

A

Vegan diet
GI surgery
IBD

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12
Q

Recall 3 reasons why folic acid absorption might be impaired

A

Coeliac
IBD
Drugs

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13
Q

Recall 3 reasons why folic acid requirement might be increased

A

Pregnancy
Malignancy
Haemolytic anaemia

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14
Q

What sorts of anaemia are caused by B12 deficiency?

A

Macrocytic and megaloblastic

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15
Q

Other than anaemia, what is a key clinical feature of B12 deficiency?

A

Neurological problems due to demyelination

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16
Q

Describe the shape of macrocytes in vit B12/ folic acid deficiency

A

oval

17
Q

How is the MCV affected by megaloblastic aneamia and why?

A

Drops

Morphological change of erythrocyte within bone marrow

18
Q

Recall the 6 stages of development of an erythrocyte

A 
Proerythroblast
Basophillic erythrocyte
Polychromatic erythrocyte
Pyknotic erythrocyte
Reticulocyte
Erythrocyte
19
Q

Describe the structure of a proerythroblast

A

Large space in middle = uncondensed chromatin

20
Q

Why are red cell precursors increased in sixe in megaloblastic anaemia?

A

Defects in DNA synthesis –> asynchronous maturation of cytoplasm and nucleus

21
Q

What is the origin of hypersegmented neutrophils?

A

Giant metamyelocytes in bone marrow due to defective DNA synthesis

22
Q

What would be seen alongside erythrocytes in the blood film of someone with B12 deficiency?

A

Fragments of red cells

23
Q

What is the gold standard test for diagnosis of B12/ folic acid deficiency, and what is a positive result?

A

Plasma homocysteine

High

24
Q

How can B12 deficiency be treated?

A

Injections

MCD Y2: Haematology (11 decks)

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