Megaloblastic Anemias (Hematology)

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Author:
narine010
ID:
208477
Filename:
Megaloblastic Anemias (Hematology)
Updated:
2013-03-20 02:00:06
Tags:
Hematology
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Description:
Anemia
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  1. What causes megaloblastic anemia?
    • Vitamin B12 deficiency
    • Folic acid deficiency
  2. Clinical Features
    • Fatigue
    • Weakness
    • Jaundice-->due to increase bilirubin
    • SOB
  3. Megaloblastic erythrocyte maturation
    • 1.  Promegaloblast
    • 2.  Basophilic Megaloblast
    • 3.  Polychromatic megaloblast
    • 4.  Diffusely basophilic macrocyte
    • 5.  macrocyte
  4. Peripheral Blood
    • Macrocytic, normochromic, RBC inclusions, decreased reticulocyte count
    • 2. Low RBC, Hgb, Hct, haptoglobin
    • 3. High MCV, MCH, erythropoietin
    • 4. Normal MCHC
    • 5.
  5. Where is B12 absorbed and transported?
    • Ileum of the SI
    • 2. Actively transported by IF (Intrinsic Factor) and TCII (transcobalamine II)
    • 3.  It is transport to Liver, Marrow and other places
  6. Where is folic acid absorbed and how is it transported?
    • 1. absorbed in the duodenum and jejunum 
    • 2. actively transported:
    • polyglutamate-->monoglutamate-->tetrahydrofolate-->liver, and cells
  7. What are the clinical features of folic acid deficiency
    • depression
    • dementia 
    • not as severe as B12 deficiency
  8. Differential Diagnosis of B12 and folic acid deficiency?
    • 1. serum B12 levels
    • 2. serum and RBC folate levels
    • 3. antibodies to intrinsic factor
    • 4. schilling's test

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