Week 7 - Vitamin B12 Deficiency Anemia

Question 1

What does vitamin B12 deficiency cause? (3)

Answer 1

• impaired DNA formation
• results in a larger than normal cell
• these abnormalities target the cell for early destruction

Question 2

What is the cause for vitamin B12 deficiency anemia? (3)

Answer 2

• can rarely be caused by dietary deficiency (vegan diets, low protein diets)
• usually caused by conditions that affect bowel such as chronic diarrhea, celiac disease or intestinal surgery
• failure to absorb B12 from lack of intrinsic factor in gut needed to uptake the vitamin (autoimmune)

Question 3

Why does neuropathy occur with Vitamin B12 deficiency?

Answer 3

lack of B12 affects nerve function

Question 4

What are the signs and symptoms of B12 deficiency anemia? (8)

Answer 4

• jaundice
• pallor
• glossitis (red, smooth beefy tongue)
• fatigue
• weight loss
• Paresthesias of feet and hands*
• serum Hgb and Hct decreased
• serum B12 decreased

Question 5

Glossitis picture

Answer 5

Question 6

What is administered for vitamin B12 deficiency anemia? (2)

Answer 6

• cyanocobalamin
• purified form of B12

Question 7

What routes can you administer cyanocobalamin? (3)

Answer 7

• oral
• intranasally
• injection

Question 8

In what instances would you administer cyanocobalamin? (2, 3)

Answer 8

1. If diet is the cause, nutritional education is required
   - may also treat underlying cause if malabsorption is the issue
2. If lack of intrinsic factor is the cause, will be treated with parenteral B12 given by injection

Question 9

Are there side/adverse effects of cyanocobalamin?

Answer 9

• it is really rare

Question 10

When should you treat vitamin B12 anemia? (2)

Answer 10

• before significant neuro symptoms
• otherwise it may not reverse