Megaloblastic Anemia Quiz L2
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Questions and Answers

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?

  • 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?

  • 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?

    <p>Impaired DNA synthesis</p> Signup and view all the answers

    What is the main characteristic that differentiates megaloblastic from non-megaloblastic macrocytic anemias?

    <p>Appearance of developing erythroblasts in the bone marrow</p> Signup and view all the answers

    What is the significance of hypersegmented neutrophils in megaloblastic anemias?

    <p>They are an important diagnostic feature of megaloblastic anemias</p> Signup and view all the answers

    What is the cause of pernicious anemia?

    <p>Defective secretion of intrinsic factor</p> Signup and view all the answers

    Which enzyme is affected by the 677 C→T mutation in the MTHFR gene?

    <p>5,10 methylene tetrahydrofolate reductase</p> Signup and view all the answers

    What is the main form of circulating B12 that is involved in the conversion of methylmalonyl CoA to succinyl CoA?

    <p>Deoxy-adenosyl-cobalamine</p> Signup and view all the answers

    What is the result of folate or vitamin B12 deficiency in the mother during pregnancy?

    <p>Elevated homocysteine and S-adenosyl homocysteine in the fetus</p> Signup and view all the answers

    What is the effect of the 5,10- methylene THF polyglutamate in cellular metabolism?

    <p>Essential for DNA synthesis</p> Signup and view all the answers

    Why is monitoring and managing gastrin levels important for individuals with pernicious anemia?

    <p>To manage potential complications like gastric cancer</p> Signup and view all the answers

    What is the main characteristic of macrocytic anemia?

    <p>Increased mean corpuscular volume (MCV)</p> Signup and view all the answers

    Which condition can cause macrocytosis or hypersegmented neutrophils without megaloblastic anemia?

    <p>Liver disease</p> Signup and view all the answers

    What are common causes of macrocytic anemia?

    <p>Alcoholism and liver disease</p> Signup and view all the answers

    What is a characteristic feature of aplastic anemia?

    <p>Reduction in blood cell production in bone marrow</p> Signup and view all the answers

    What are the main nutritional deficiencies associated with macrocytic anemia?

    <p>Folate and vitamin B12 deficiencies</p> Signup and view all the answers

    What is the impact of chronic alcohol use on RBC production?

    <p>Suppresses bone marrow, affecting RBC production</p> Signup and view all the answers

    What are the clinical features of megaloblastic anemia?

    <p>Jaundice, glossitis, and signs of anemia</p> Signup and view all the answers

    What is the role of vitamin B12 in the body?

    <p>Conversion of methionine to S-adenosylmethionine for myelin synthesis</p> Signup and view all the answers

    What are the hematological findings associated with folate deficiency?

    <p>Macrocytic anemia, anisocytosis, and hypersegmented neutrophils</p> Signup and view all the answers

    What can cause vitamin B12 deficiency?

    <p>Lack of intrinsic factor secreted by gastric parietal cells</p> Signup and view all the answers

    What is the treatment for folate deficiency?

    <p>Folic acid supplements and addressing the underlying cause</p> Signup and view all the answers

    What are the causes of megaloblastic anemia?

    <p>Vitamin B12 or folate deficiency or antifolate drugs</p> Signup and view all the answers

    What is the average daily intake of Folate in adults?

    <p>200-250 μg</p> Signup and view all the answers

    Which vitamin has a dietary source that includes most foods, especially liver, green vegetables, and yeast?

    <p>Vitamin B12</p> Signup and view all the answers

    What are the forms of Folate supplementation?

    <p>Dietary supplement, multivitamin</p> Signup and view all the answers

    Which condition responds to uridine and is not related to Cobalamin or Folate deficiency?

    <p>Orotic aciduria</p> Signup and view all the answers

    What are the causes of Vitamin B12 deficiency?

    <p>Malabsorption, Inadequate intake, Intrinsic factor deficiency, Long-term dialysis</p> Signup and view all the answers

    What are the mechanisms of folate deficiency caused by anticonvulsant therapy?

    <p>Impaired absorption, Increased metabolism, Altered folate metabolism</p> Signup and view all the answers

    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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    Megaloblastic Anemia Lecture Notes PDF

    Description

    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.

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