Megaloblastic Anemia Quiz

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Questions and Answers

Which cells are present in the bone marrow examination of megaloblastic anemia?

  • Megaloblasts (correct)
  • Leukocytes
  • Metamyelocytes
  • Erythrocytes

What are the causes of delayed nuclear maturation in megaloblastic anemia?

  • B12 deficiency or abnormal metabolism
  • B9 deficiency or abnormal metabolism
  • Congenital enzyme deficiencies in DNA synthesis
  • All of the above (correct)

Apart from nutrient deficiencies, what are other potential causes of delayed nuclear maturation in megaloblastic anemia?

  • Increased red blood cell destruction
  • Impaired iron absorption
  • Excessive folic acid intake
  • Myelodysplasia due to dyserythropoiesis (correct)

Which of the following nutrients is involved in the conversion of homocysteine to methionine, an essential step in DNA synthesis?

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

Which of the following is a characteristic finding in the blood film of a patient with megaloblastic anemia?

<p>Oval macrocytes (B)</p> Signup and view all the answers

Which red blood cell parameter is typically elevated in megaloblastic anemia?

<p>MCV (Mean Corpuscular Volume) (A)</p> Signup and view all the answers

Which of the following is a potential finding in the bone marrow examination of a patient with megaloblastic anemia?

<p>Hypersegmented polymorphonuclears (PMN's) (A)</p> Signup and view all the answers

Which cell in the stomach synthesizes gastric intrinsic factor (IF)?

<p>Gastric parietal cell (C)</p> Signup and view all the answers

What is the primary site of absorption for vitamin B12?

<p>Ileum (C)</p> Signup and view all the answers

What is the approximate absorption rate of vitamin B12?

<p>40% (C)</p> Signup and view all the answers

How long does it typically take for disease manifestation in vitamin B12 deficiency?

<p>2-4 years (B)</p> Signup and view all the answers

What is the common cause of vitamin B12 deficiency?

<p>Small intestine pathology (A)</p> Signup and view all the answers

Which of the following is a common symptom associated with neurological changes in vitamin B12 deficiency?

<p>Dementia (D)</p> Signup and view all the answers

Which of the following clinical features is commonly associated with pernicious anemia?

<p>Lemon yellow (B)</p> Signup and view all the answers

Which neurological changes can occur in pernicious anemia?

<p>Peripheral polyneuropathy (A)</p> Signup and view all the answers

What is the initial treatment for pernicious anemia?

<p>Hydroxocobalamin 1 mg IM per week x 3 doses (D)</p> Signup and view all the answers

Which vitamin is involved in the methylation of myelin in the peripheral nerves?

<p>Vitamin B12 (cobalamin) (D)</p> Signup and view all the answers

Which part of the gastrointestinal tract is primarily responsible for the absorption of dietary folic acid?

<p>Jejunum (A)</p> Signup and view all the answers

What is the main transport protein for folic acid in the body?

<p>Albumin (C)</p> Signup and view all the answers

Which of the following conditions can lead to folic acid deficiency?

<p>Alcoholism (A)</p> Signup and view all the answers

What are the clinical features of folic acid deficiency?

<p>Neural tube defects in newborns (D)</p> Signup and view all the answers

What is the recommended daily dose of folic acid during a normal pregnancy?

<p>400ug (C)</p> Signup and view all the answers

What is the treatment for folic acid deficiency?

<p>Folic acid tablets (D)</p> Signup and view all the answers

In which conditions is folic acid given as prophylaxis during pregnancy?

<p>Previous child with neural tube defects (B)</p> Signup and view all the answers

Which nutrient deficiency is associated with microcytic, hypochromic anemia?

<p>Iron (A)</p> Signup and view all the answers

Which of the following is a common clinical feature of folic acid deficiency?

<p>Glossitis (B)</p> Signup and view all the answers

Which of the following conditions is NOT a cause of folic acid deficiency?

<p>Hypothyroidism (D)</p> Signup and view all the answers

Which nutrient deficiency can result in microcytic, hypochromic anemia?

<p>Iron (A)</p> Signup and view all the answers

Which nutrient deficiency can cause macrocytic (megaloblastic) anemia along with neurologic manifestations?

<p>Cobalamin (B12) (D)</p> Signup and view all the answers

Which nutrient deficiency can lead to macrocytic (megaloblastic) anemia and neural tube defects (NTD)?

<p>Folic acid (D)</p> Signup and view all the answers

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Study Notes

Megaloblastic Anemia

  • Cells present in bone marrow examination: megaloblasts, giant metamyelocytes, and abnormal white blood cells
  • Causes of delayed nuclear maturation:
    • Deficiency of vitamin B12 and/or folate
    • Impaired DNA synthesis
  • Other potential causes of delayed nuclear maturation:
    • Inherited disorders
    • Toxic effects of certain medications
    • Myelodysplastic syndrome

Vitamin B12

  • Involved in conversion of homocysteine to methionine, an essential step in DNA synthesis
  • Characteristic finding in blood film: macrocytic anemia
  • Red blood cell parameter typically elevated: mean corpuscular volume (MCV)
  • Potential finding in bone marrow examination: megaloblasts
  • Cell in the stomach synthesizing gastric intrinsic factor (IF): parietal cells
  • Primary site of absorption: terminal ileum
  • Approximate absorption rate: 1-2% of dietary intake
  • Time for disease manifestation: 2-5 years
  • Common cause of deficiency: pernicious anemia
  • Common symptom associated with neurological changes: numbness or tingling in hands and feet
  • Clinical feature commonly associated with pernicious anemia: atrophic gastritis
  • Neurological changes: demyelination, neuronal death, and cognitive impairment
  • Initial treatment: vitamin B12 injections
  • Involved in methylation of myelin in peripheral nerves

Folic Acid

  • Primary site of absorption: proximal jejunum
  • Main transport protein: folate-binding protein
  • Conditions leading to deficiency:
    • Inadequate dietary intake
    • Malabsorption
    • Increased demand (e.g., pregnancy)
  • Clinical features:
    • Macrocytic anemia
    • Fatigue
    • Weakness
  • Recommended daily dose during pregnancy: 1 mg
  • Treatment: oral folic acid supplementation
  • Conditions requiring prophylaxis during pregnancy:
    • History of neural tube defects (NTD)
    • Family history of NTD

Other Nutrient Deficiencies

  • Iron deficiency: microcytic, hypochromic anemia
  • Folic acid deficiency: macrocytic anemia, neural tube defects (NTD)
  • Vitamin B12 deficiency: macrocytic anemia, neurologic manifestations

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