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30 Cards in this Set
- Front
- Back
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B12 and Folate def are what kind of anemias/
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megaloblastic or they have increased MCV
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B12 and Folate def may from abnormal erythropoiesis in bone marrow, or the RBCs may do what following release?
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enlarge
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What is an external bone marrow cause of B12 and Folate def?
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plasma lipid abnormality (liver dz and hypothyroidism)
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What test are helpful to run in megaloblastic anemia?
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-hx of alcohol abuse and liver problems
-CBC, blood film -retic count -B12/Folate levels -bone marrow exam |
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Can you tell the difference btw B12 and folate def on clinical presentation?
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NO
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B12 def causes what?
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demylelination in the spinal cord and peripheral nerves
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It takes how long to run out of folic acid stores?
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3 months
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It takes how long to run out of B12 stores?
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3 years
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B12 needs what to be absorbed?
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IF
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Where is B12 absorbed in the body?
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distal ileium
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What is the protein in the blood that transports B12?
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transcobalamin-II
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How much B12 is need daily?
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100mcg
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What are some causes of B12 def?
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-pernicious anemia
-elderly person -absorption defects |
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What is pernicious anemia?
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autoimmune attack on gastric parietal cells, and they have no IF
-often associated with vitiligo and thyroid dz |
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What are some things that can cause absorption defects that results in B12 defiency?
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-congenital
-gastrectomy -Crohns -tropical sprue -blind loop syndrome -fish tapeworm |
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Folate is absorbed where?
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jejunum
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What are some causes of folate defiency?
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-inadequate intake
-malabsorption -excessive utilization -drugs |
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What are some malabsorption syndrome that can cause folate def?
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-Celiac disease
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What are some excessive utilization syndromes that can cause folate defiency?
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-pregnancy
-hemolysis -tumors |
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What are some drugs that can cause folate def/
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-anticonvulsants like dilantin
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What are some clinical features of B12 and folate defiency?
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-sore tongue
-affected gut mucosa -malaise -fatigue -weight loss -diarrhea -loss of appetie -fever -pallor -mild jaundice -fever -fundal hemorrhages -glossitis |
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B12 produces what kind of side effects?
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neurological
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What is often the first sign of folate defiency?
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gingival hyperplasia is first sign
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MCV is what in B12 and folate def?
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high
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LDH is what in B12 and Folate def?
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high
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Retic count is what in B12 and Folate def?
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low
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What is seen on smear for B12 deficiency?
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hypersegmented neutrophils
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Folate can be replaced how?
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-5mg PO daily
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How can B12 be replaced?
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oral-high dose 1mg day
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After you start therapy for B12 and folate def. you will get maximal reticulosytosis when?
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in 7 days
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