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28 Cards in this Set
- Front
- Back
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round macro cytosis is non or megaloblastic
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round is non-megaloblastic
oval is megaloblastic |
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list some causes of megaloblastic macrocytic anemia
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b12 deficinency
chemotherapeutic or retrovrial rx myelodysplastic syndromes impaired b12.folate absorption drugs (contraceptives, antoconvulsants) toxins |
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round macrocytosis non-megaloblastic causes
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alcoholism
liver disease rarely renal disease |
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oval macrocytosis megaloblastic define
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dna replication problem, cytoplasm grows while nucleus lags behind
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folate/b12 deficiency-PMNS are usually
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hypersegmented
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myelodysplasia- PMNS are generally
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hyposegmented
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what happens with extreme leuhkocytosis (chronic lymphocytic leukemia)
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automated counters count wbcs as rbcs
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what would a patient with megaloblastic anemia present like
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lethargy, weakness, pallor
atrophy of muscle surfaces, GI, tongue, vaginal consider in all infants that fail to thrive |
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if you suspect b12 deficiency, it would be because
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neurologic disturbance, gait problems, neuropathys, parathesias
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labs for megaloblastic anemia
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macrocytic normochromic
MCV >100 MCH increase, MCHC normal RDW elevated, low reticulocytes, *MCV could be normal if concurrent iron deficiency |
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triad of cells in megaloblastic anemia
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oval macrocytes, howell-jolly bodies, hypersegemented neutrophils
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In megaloblastic anemia, neutrophils are
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left shifted and larger than normal
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folic acid deficiency leads to a block in conversion of..
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dUMP to dTMP...so blocks DNA synthesis
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recommneded allowance for folic acid
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200 micrograms a day
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folic acid deficiency...first morophologic observation
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hypersegmented neutrophils
11 weeks |
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anemia appears at how many weeks with folic acid deficiecncy
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20 weeks
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cobalamin b12 is necessary for
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synthesis of methionine, central reaction in DNA synthesis
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b12 defiency is usually dietary or non-dietary
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non-dietary unless strict vegetarian or achlorhydira, partial gastrectomy
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b12 deficiency comes from
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deficient intrinsic facotr (destruction of parietal cells, eg. pernicious anemia)
malabsorptions, pancreatic insuffinciency, removed ileum |
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most common cause of b12 deficiency
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pernicious anemia
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two other diseases pernicious anemia can occur with
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graves, hashimotos
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define pernicious anemia
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megalblastic anemia due to absemce of IF secondary to gastric atrophy
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lab Dx for pernicious anemia
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test for anti-parietal antibodies
gastrin test: serum level increase in PA |
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in megaloblastic anemia, descrbibe RBC folate and LDH and bilirubin
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RBC folate: red cells metabolically inactive, reflect folate status at time they were produced
LDH is elevated macrocytes are fragile and lyse indirect bilirubin is elevated |
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homocysteine levels in b12 and folate deficiency
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elevated in both
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methylmalonic acid levels in b12 and folate defiency
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elevated in b12, normal in folate deficiency
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if you have macrocytic anemia without megaloblastosis, describe findings
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round macrocytes, not oval
not hypersegmented PMNS no glossitis and neuropathy alcoholism |
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name somes drugs that can cause megalobastic macrocytic anemia
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chemotherapeutic: methotrexate, hydroxyurea, cytosine arabinoside
antiretrovirals |
