30 Questions
Which cells are present in the bone marrow examination of megaloblastic anemia?
Megaloblasts
What are the causes of delayed nuclear maturation in megaloblastic anemia?
All of the above
Apart from nutrient deficiencies, what are other potential causes of delayed nuclear maturation in megaloblastic anemia?
Myelodysplasia due to dyserythropoiesis
Which of the following nutrients is involved in the conversion of homocysteine to methionine, an essential step in DNA synthesis?
Vitamin B12
Which of the following is a characteristic finding in the blood film of a patient with megaloblastic anemia?
Oval macrocytes
Which red blood cell parameter is typically elevated in megaloblastic anemia?
MCV (Mean Corpuscular Volume)
Which of the following is a potential finding in the bone marrow examination of a patient with megaloblastic anemia?
Hypersegmented polymorphonuclears (PMN's)
Which cell in the stomach synthesizes gastric intrinsic factor (IF)?
Gastric parietal cell
What is the primary site of absorption for vitamin B12?
Ileum
What is the approximate absorption rate of vitamin B12?
40%
How long does it typically take for disease manifestation in vitamin B12 deficiency?
2-4 years
What is the common cause of vitamin B12 deficiency?
Small intestine pathology
Which of the following is a common symptom associated with neurological changes in vitamin B12 deficiency?
Dementia
Which of the following clinical features is commonly associated with pernicious anemia?
Lemon yellow
Which neurological changes can occur in pernicious anemia?
Peripheral polyneuropathy
What is the initial treatment for pernicious anemia?
Hydroxocobalamin 1 mg IM per week x 3 doses
Which vitamin is involved in the methylation of myelin in the peripheral nerves?
Vitamin B12 (cobalamin)
Which part of the gastrointestinal tract is primarily responsible for the absorption of dietary folic acid?
Jejunum
What is the main transport protein for folic acid in the body?
Albumin
Which of the following conditions can lead to folic acid deficiency?
Alcoholism
What are the clinical features of folic acid deficiency?
Neural tube defects in newborns
What is the recommended daily dose of folic acid during a normal pregnancy?
400ug
What is the treatment for folic acid deficiency?
Folic acid tablets
In which conditions is folic acid given as prophylaxis during pregnancy?
Previous child with neural tube defects
Which nutrient deficiency is associated with microcytic, hypochromic anemia?
Iron
Which of the following is a common clinical feature of folic acid deficiency?
Glossitis
Which of the following conditions is NOT a cause of folic acid deficiency?
Hypothyroidism
Which nutrient deficiency can result in microcytic, hypochromic anemia?
Iron
Which nutrient deficiency can cause macrocytic (megaloblastic) anemia along with neurologic manifestations?
Cobalamin (B12)
Which nutrient deficiency can lead to macrocytic (megaloblastic) anemia and neural tube defects (NTD)?
Folic acid
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
Test your knowledge of megaloblastic anemia, a condition characterized by the presence of megaloblasts in the bone marrow. Discover the causes and factors that contribute to delayed nuclear maturation in this informative quiz.
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