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32 Cards in this Set
- Front
- Back
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MCV of macrocytic anemia
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>100fL
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two categories of macrocytic anemias
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round (non-megaloblastic)
oval (megaloblastic) |
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causes of megaloblastic macrocytic anemia
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B12/folate deficiency
myelodysplasia chemo |
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causes of non-megaloblastic macrocytic anemia
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alcoholism
liver disease |
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why are cells large in macrocytic megaloblastic anemia
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DNA cant replicate so cells grow, but can't divide
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cause of oval macrocytic anemia where PMNS are hypersegmented
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folate/B12 deficiency
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cause of oval macrocytic anemia where PMNs are hyposegmented
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myelodysplasia
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causes of spurious (pseudo) increased MCV
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cold agglutinins
hyperglobulinemia autoantibody production increased reticulocytes Rouleaux formation (RBC clumps) extreme leukocytosis |
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clinical signs of megaloblastic anemia
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-atrophy of mucosal surfaces that can cause malabsorption (tongue, GI, vagina)
neurologic sx (B12 deficient) |
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neuro sx of B12 deficiency
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parasthesia
abnormal gait psycho disorders |
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RDW in megaloblastic macrocytic anemia
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increased (anisocytosis)
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triad of findings seen in peripheral blood smear in megaloblastic macrocytic anemia
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oval macrocytes
Howell-jolly bodies hypersegmented neutrophils |
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howell-jolly bodies
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megaloblastic macrocytic anemia
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causes of increased folate requirements
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pregnancy
hemolytic anemia |
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drugs that can cause folate deficiency
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oral contraceptives
long term anticoagulants phenobarbitol |
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stores folic acid which is used in deficiency
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liver
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first sign of folic acid deficiency
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hypersegmented neutrophils
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B12 is needed for the synthesis of what
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methionine
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stores of B12 can last how long without any intake
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2-6 years
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what is pernicious anemia
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autoantibodies to parietal cells cause a decrease in intrinsic factor which causes a B12 deficiency anemia
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B12 absorption
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binds R-binding protein (stomach)
protease digestion of R protein and binding to IF (duodenum) absorption (ileum) |
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B12 is absorbed in what part of the small intestine
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ileum
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most common cause of B12 deficiency
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pernicious anemia
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pernicious anemia occurs with what other autoIg disease
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Graves
Hashimoto |
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two tests for pernicious anemia
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serologic test for anti-parietal
gastrin test: increase in PA |
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best measure of folate levels
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RBC folate level
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how to distinguish between folate and B12 deficiency
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-methylmalonic acid: elveated in B12; normal in folate
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two metabolites measured in megaloblastic anemias
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total homocysteine
methylmalonic acid |
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consider in all infants with failure to thrive
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megaloblastic anemia (B12/folate deficiency)
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order of sx in B12/folate deficiency
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neurologic sx
hematologic sx |
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what is a howell jolly body
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fragment of DNA left inside cell
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folate of B12 deficiency is caused by a dietary inadequacy
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folate
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