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Questions and Answers
What is the main characteristic of macrocytic anemia?
What is the main characteristic of macrocytic anemia?
- Decreased red blood cell count
- Abnormally large red blood cells (correct)
- Increased hemoglobin levels
- Elevated platelet count
What is the significance of hypersegmented neutrophils in the diagnosis of megaloblastic anemias?
What is the significance of hypersegmented neutrophils in the diagnosis of megaloblastic anemias?
- They indicate normocytic anemia
- They are an important diagnostic feature of megaloblastic anemias (correct)
- They are unrelated to the type of anemia
- They suggest non-megaloblastic anemias
What distinguishes megaloblastic from non-megaloblastic (normoblastic) macrocytic anemias?
What distinguishes megaloblastic from non-megaloblastic (normoblastic) macrocytic anemias?
- Red blood cell shape abnormalities
- Platelet count
- Appearance of developing erythroblasts in the bone marrow (correct)
- Hemoglobin levels in the blood
What is the cause of macrocytic anemia?
What is the cause of macrocytic anemia?
What is the main characteristic that differentiates megaloblastic from non-megaloblastic macrocytic anemias?
What is the main characteristic that differentiates megaloblastic from non-megaloblastic macrocytic anemias?
What is the significance of hypersegmented neutrophils in megaloblastic anemias?
What is the significance of hypersegmented neutrophils in megaloblastic anemias?
What is the cause of pernicious anemia?
What is the cause of pernicious anemia?
Which enzyme is affected by the 677 C→T mutation in the MTHFR gene?
Which enzyme is affected by the 677 C→T mutation in the MTHFR gene?
What is the main form of circulating B12 that is involved in the conversion of methylmalonyl CoA to succinyl CoA?
What is the main form of circulating B12 that is involved in the conversion of methylmalonyl CoA to succinyl CoA?
What is the result of folate or vitamin B12 deficiency in the mother during pregnancy?
What is the result of folate or vitamin B12 deficiency in the mother during pregnancy?
What is the effect of the 5,10- methylene THF polyglutamate in cellular metabolism?
What is the effect of the 5,10- methylene THF polyglutamate in cellular metabolism?
Why is monitoring and managing gastrin levels important for individuals with pernicious anemia?
Why is monitoring and managing gastrin levels important for individuals with pernicious anemia?
What is the main characteristic of macrocytic anemia?
What is the main characteristic of macrocytic anemia?
Which condition can cause macrocytosis or hypersegmented neutrophils without megaloblastic anemia?
Which condition can cause macrocytosis or hypersegmented neutrophils without megaloblastic anemia?
What are common causes of macrocytic anemia?
What are common causes of macrocytic anemia?
What is a characteristic feature of aplastic anemia?
What is a characteristic feature of aplastic anemia?
What are the main nutritional deficiencies associated with macrocytic anemia?
What are the main nutritional deficiencies associated with macrocytic anemia?
What is the impact of chronic alcohol use on RBC production?
What is the impact of chronic alcohol use on RBC production?
What are the clinical features of megaloblastic anemia?
What are the clinical features of megaloblastic anemia?
What is the role of vitamin B12 in the body?
What is the role of vitamin B12 in the body?
What are the hematological findings associated with folate deficiency?
What are the hematological findings associated with folate deficiency?
What can cause vitamin B12 deficiency?
What can cause vitamin B12 deficiency?
What is the treatment for folate deficiency?
What is the treatment for folate deficiency?
What are the causes of megaloblastic anemia?
What are the causes of megaloblastic anemia?
What is the average daily intake of Folate in adults?
What is the average daily intake of Folate in adults?
Which vitamin has a dietary source that includes most foods, especially liver, green vegetables, and yeast?
Which vitamin has a dietary source that includes most foods, especially liver, green vegetables, and yeast?
What are the forms of Folate supplementation?
What are the forms of Folate supplementation?
Which condition responds to uridine and is not related to Cobalamin or Folate deficiency?
Which condition responds to uridine and is not related to Cobalamin or Folate deficiency?
What are the causes of Vitamin B12 deficiency?
What are the causes of Vitamin B12 deficiency?
What are the mechanisms of folate deficiency caused by anticonvulsant therapy?
What are the mechanisms of folate deficiency caused by anticonvulsant therapy?
Study Notes
- Megaloblastic Anemia can be caused by deficiencies or abnormalities of Cobalamin (B12) and Folate.
- Causes of Megaloblastic Anemia not related to Cobalamin or Folate deficiency: a. Some cases of acute myeloid leukaemia, myelodysplasia, b. Orotic aciduria (responds to uridine), c. Therapy with drugs interfering with synthesis of DNA (e.g. cytosine arabinoside, hydroxyurea, 6-mercaptopurine, azidothymidine (AZT)), d. Thiamine responsive.
- Other rare causes suggested but poorly documented: a. Vitamin E deficiency, b. Lesch-Nyhan syndrome (responds to adenine).
- Other causes of megaloblasts: a. Abnormalities of nucleic acid synthesis, b. Orotic aciduria, Drug therapy: 1-Antipurines (mercaptopurine,azathioprine), 2-Antipyrimidines (fluorouracil, zidovudine (AZT)), 3-Others (hydroxyurea).
- Myelodysplastic syndromes, erythroleukaemia, Some congenital dyserythropoietic anaemias, Uncertain aetiology.
- Vitamin B12 & Folate:
- Dietary source: Vitamin B12: Only food of animal origin, especially liver. Folate: Most foods, especially liver, green vegetable and yeast.
- Average daily intake: In adults: Vitamin B12: 7-30 μg, Folate: 200-250 μg.
- Body stores: Vitamin B12: 3-5 mg, mainly in the liver. Folate: 8-20 mg, mainly in the liver.
- Time to develop deficiency: Anemia in 2-10 years, Macrocytosis in 5 months.
- Structure: Vitamin B12: Methylcobalamin, Adenosylcobalamin, Hydroxocobalamin, Cyanocobalamin. Folate: Tetrahydrofolic acid (THF), Methyl THF.
- Forms: Vitamin B12: Injection, oral tablet, nasal spray, liquid. Folate: Dietary supplement, multivitamin.
- Causes of Vitamin B12 & Folate deficiency: Vitamin B12 deficiency: Malabsorption, Inadequate intake, Intrinsic factor deficiency, Long-term dialysis, Congenital intrinsic factor deficiency. Folate deficiency: Malabsorption, Inadequate intake, Increased requirement, Anticonvulsant therapy, Ethanol abuse, Certain anticonvulsant medications, Pregnancy, Premature infants, Chronic haemolytic anaemias, Myelofibrosis, Various malignant diseases, Increased loss.
- Mechanisms of folate deficiency caused by anticonvulsant therapy: 1. Impaired absorption, 2. Increased metabolism, 3. Altered folate metabolism.
- Manifestations of Vitamin B12 & Folate deficiency: Neurological: Megaloblastic anemia, Severe Megaloblastic anemia, Neuropathy, Neuropathy due to Vit B12 and folate deficiency. Hematological: Neural tube defect. Psychiatric symptoms.
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Test your knowledge about the causes of megaloblastic anemia including B12 and folate deficiencies, therapy-related causes, and independent factors. Discover the various factors that contribute to this type of anemia.
