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cueFlash >Decks >Megaloblastic Anemias >Glossary  

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Glossary of megaloblastic anemias

Created by jyhlin

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Megaloblastic Anemia:Biochemical Abnormality 

Thymidine monophosphate (TMP) is needed for normal DNA synthesisDecreases in TMP synthesis from uridine monophosphate (UMP) results in abnormal DNA synthesisDefective nuclear maturation and megaloblastic morphologyim

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Card Front<p>Megaloblastic Anemia:</p><p>Biochemical Abnormality </p>

Card Back<ul><li>Thymidine monophosphate (TMP) is needed for normal DNA synthesis</li><li>Decreases in TMP synthesis from uridine monophosphate (UMP) results in abnormal DNA synthesis</li><li>Defective nuclear maturation and megaloblastic morphology</li><ul><li>im

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Folic Acid - Source

water-soluble vitamingreen, leafy veggiesfruits, dairy products, cereals,liver, kidney

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Card FrontFolic Acid - Source<br />

Card Back<ul><li>water-soluble vitamin</li><li>green, leafy veggies</li><li>fruits, dairy products, cereals,</li><li>liver, kidney<br /></li></ul>

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Folic Acid- Clinical features

typical megaloblastic picture in bone marrow and bloodneurological problemsnot as severe as in B12depressio, dementia in some

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Card FrontFolic Acid- Clinical features<br />

Card Back<ul><li>typical megaloblastic picture in bone marrow and blood</li><li>neurological problems</li><ul><li>not as severe as in B12</li><li>depressio, dementia in some </li></ul></ul>

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Folic Acid- Etiology

Dietarypoverty, aginealcoholismMalabsorptiontropical sprueIncreased requirement
pregnancy, infancycancerDrugs

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Card FrontFolic Acid- Etiology<br />

Card Back<ul><li>Dietary</li><ul><li>poverty, agine</li><li>alcoholism</li></ul><li>Malabsorption</li><ul><li>tropical sprue</li></ul><li>Increased requirement <br /></li><ul><li>pregnancy, infancy</li><li>cancer</li></ul><li>Drugs<br /></li></ul>

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Folic Acid- Nutritional requirements

Intake400-600 ug/day in avg diet50-100 ug/day recommendeddepend on body's needsovercooking foods destroys folic acid and causes deficiencyBody stores 5-10 mg in many tissuestakes o

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Card FrontFolic Acid- Nutritional requirements<br />

Card Back<ul><li>Intake</li><ul><li>400-600 ug/day in avg diet</li><li>50-100 ug/day recommended</li><li>depend on body's needs</li><li>overcooking foods destroys folic acid and causes deficiency</li></ul><li>Body stores 5-10 mg in many tissues</li><li>takes o

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Lab findings for B12 and Folic Acid Deficiencies

serum B12 levelsserum and RBC folate levelsAntibodies to IFSchilling's test evaluates B12 absorption from GI tract (radioactive test)Vitamin B12 deficiency
oral therapyinjections

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Card FrontLab findings for B12 and Folic Acid Deficiencies

Card Back<ul><li>serum B12 levels</li><li>serum and RBC folate levels</li><li>Antibodies to IF</li><li>Schilling's test evaluates B12 absorption from GI tract (radioactive test)</li><li>Vitamin B12 deficiency<br /></li><ul><li>oral therapy</li><li>injections</

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Megaloblastic Anemia - Etiology

Vitamin B12 deficiencyFolicacid deficiency

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Card FrontMegaloblastic Anemia - Etiology<br />

Card Back<ul><li>Vitamin B12 deficiency</li><li>Folicacid deficiency<br /></li></ul>

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Megaloblastic Anemia- Clinical features

fatigueweakenessshortness of breathlightheadednesssome jaundice in severe cases due to increased bilirubincongestive heart failure possible in severe cases

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Card FrontMegaloblastic Anemia- Clinical features<br />

Card Back<ul><li>fatigue</li><li>weakeness</li><li>shortness of breath</li><li>lightheadedness</li><li>some jaundice in severe cases due to increased bilirubin</li><li>congestive heart failure possible in severe cases<br /></li></ul>

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Megaloblastic Anemia: Bone marrow

ineffective hematopoiesis in RBC, WBC, plateletshypercellular marrow: bone marrow making more because of lack of proper growthM:E ratio can be from 1:1 to 1:3Asynchronous development between nucleus and cytoplasm

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Card FrontMegaloblastic Anemia: Bone marrow<br />

Card Back<ul><li>ineffective hematopoiesis in RBC, WBC, platelets</li><li>hypercellular marrow: bone marrow making more because of lack of proper growth</li><li>M:E ratio can be from 1:1 to 1:3</li><li>Asynchronous development between nucleus and cytoplasm</li></u

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Megaloblastic Anemia: Maturation

Promegaloblasbig hoffstain more acid because bigger nucleus
Basophilic megaloblastred, young nucleus lagging behind--> not making enough DNA (lack TMP)
polychromatic megal

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Card FrontMegaloblastic Anemia: Maturation

Card Back<ul><li>Promegaloblas</li><ul><li>big hoff</li><li>stain more acid because bigger nucleus<br /></li></ul><li>Basophilic megaloblast</li><ul><li>red, young nucleus lagging behind--> not making enough DNA (lack TMP)<br /></li></ul><li>polychromatic megal

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Megaloblastic Anemia: Peripheral Blood

Erythrocytemacrocytic, normochromicRBC: 1-3 x10^6/ul; Hgb: 6-9 g/dl; Hct: 20-30%MCV: 100-160 fL; MCH: increased; MCHC: normalMorphology: macrocytes, macroovalocytes, A&P, decreased reticulocyte count, RB

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Card FrontMegaloblastic Anemia: Peripheral Blood<br />

Card Back<ul><li>Erythrocyte</li><ul><li>macrocytic, normochromic</li><li>RBC: 1-3 x10^6/ul; Hgb: 6-9 g/dl; Hct: 20-30%</li><li>MCV: 100-160 fL; MCH: increased; MCHC: normal</li><li>Morphology: macrocytes, macroovalocytes, A&P, decreased reticulocyte count, RB

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Non-Megaloblastic Causes of Macrocytosis

chronic liver diseasealcoholismacute hemorrhage: lose B12 and folate in RBC, speed up RBC butr not right size

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Card FrontNon-Megaloblastic Causes of Macrocytosis<br />

Card Back<ul><li>chronic liver disease</li><li>alcoholism</li><li>acute hemorrhage: lose B12 and folate in RBC, speed up RBC butr not right size </li></ul>

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Vitamin B12 deficiency- Clinical features

typical megaloblastic picture in bone marrow and bloodNeurological problemsdegeneration of peripheral nervesdegeneration of spinal cord

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Card FrontVitamin B12 deficiency- Clinical features<br />

Card Back<ul><li>typical megaloblastic picture in bone marrow and blood</li><li>Neurological problems</li><ul><li>degeneration of peripheral nerves</li><li>degeneration of spinal cord<br /></li></ul></ul>

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Vitamin B12 deficiency- Etiology

Dietarypoor dietmothers who are strict vegetarian may have children who are deficientmalabsorptionpernicious anemiadecreased Instrinsic Factor due to parietal cell atrophy

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Card FrontVitamin B12 deficiency- Etiology

Card Back<ul><li>Dietary</li><ul><li>poor diet</li><li>mothers who are strict vegetarian may have children who are deficient</li></ul><li>malabsorption</li><ul><li>pernicious anemia</li><ul><li>decreased Instrinsic Factor due to parietal cell atrophy</li></ul><li>

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Vitamin B12

produced by microorganisms and fungiliver, fish, poultry, meat, eggsIntake: 5-30 ug/daydependent on body's needs1-5 ug/day absorbedBody stores 1-5 mg Vit B12B12 loss is ab

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Card FrontVitamin B12<br />

Card Back<ul><li>produced by microorganisms and fungi</li><li>liver, fish, poultry, meat, eggs</li><li>Intake: </li><ul><li>5-30 ug/day</li><li>dependent on body's needs</li><li>1-5 ug/day absorbed</li></ul><li>Body stores 1-5 mg Vit B12</li><li>B12 loss is ab

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