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narine010
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What causes megaloblastic anemia?
- Vitamin B12 deficiency
- Folic acid deficiency
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Clinical Features
- Fatigue
- Weakness
- Jaundice-->due to increase bilirubin
- SOB
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Megaloblastic erythrocyte maturation
- 1. Promegaloblast
- 2. Basophilic Megaloblast
- 3. Polychromatic megaloblast
- 4. Diffusely basophilic macrocyte
- 5. macrocyte
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Peripheral Blood
- Macrocytic, normochromic, RBC inclusions, decreased reticulocyte count
- 2. Low RBC, Hgb, Hct, haptoglobin
- 3. High MCV, MCH, erythropoietin
- 4. Normal MCHC
- 5.
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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
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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
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What are the clinical features of folic acid deficiency
- depression
- dementia
- not as severe as B12 deficiency
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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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