VIT B12 AND FOLIC ACID DEFICIENCY Flashcards
what are the roles of vit B12 and folate?
DNA synthesis
absence leads to severe anaemia
folate for Homocystine metabolism
what are the clinical features of vit B12 and folate deficiency?
Anemia: weak, tired, short of breath Jaundice Glossitis and angular cheilosis Weight loss, change of bowel habit Sterility
define macrocytic
Average red cell size is above the normal range
which conditions/ what reasons would someone have macrocytic anaemia
Vitamin B12/folate deficiency
Liver disease or alcohol
Hypothyroid
Drugs e.g. azathioprine
Haematological disorders:
- Myelodysplasia,
- aplastic anemia
- Reticulocytosis e.g. chronic haemolytic anemia
define Megaloblastic
Describes a morphological change in the red cell precursors within the bone marrow
Give 3 tests that you would do if someone had a macrocytosis
raised MCV
- folate and vit B12 test
- thyroid function tests
- liver function tests
- reticulocyte test
what food contains folate?
fresh leafy vegetables
but easily destroyed by cooking/canning/processing
how would you diagnose folate deficiency?
FBC and film
folate levels in the blood
what are the consequences of folate deficiency?
megaloblastic, macrocytic anaemia
what are some causes of vit B12 deficiency?
poor absorption (complicated mechanism of absorption)
reduced dietary intake (found in all animal products) vegans are at risk
infections/infestations (eg. abnormal bacteria flora, fish tapeworm)
what 3 things are essential for B12 absorption?
intact stomach
intrinsic factor
functioning small intestine
what is pernicious anaemia?
Autoimmune condition associated with SEVERE LACK OF intrinsic factor
what antibodies are present in someone with pernicious anaemia?
intrinsic factor antibodies
parietal cell antibodies
what causes small bowel malabsorption?
crohns
coeliac disease
surgical resection
what infections may lead to B12 deficiency?
H Pylori
Giardia
Fish tapeworm
Bacterial overgrowth
what drugs are associated with B12 deficiency?
Metformin
Proton pump inhibitors e.g. omeprazole
Oral contraceptive pill
what is the treatment for vit B12 deficiency?
take B12 tablets
inject with B12 (1000ug)- 3x week for 2 weeks and there after every 3 months
