Macrocytic Anemia
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| Definition of Macrocytosis | show 🗑
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| What is the bioche mical significance of megablastic anemia? | show 🗑
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| show | (1) Oval macrocytes (2) Hypersegmented PMN (3) Pancytopenia (4) "Giant" bands
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| show | Anemia is a result of defective de novo DNA synthesis. With folate deficiency, dUTOP accumulates replacing dTTP in newly synthesized DNA. The faulty sequences are excised but repiar is not possible due to the lack of dTTP.
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| What is the importance of vitamin B12 in folate metabolism? | show 🗑
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| show | In the stomach, vit B12 dissociated from food and binds to R protein. In the duodenum, B12 is released from R protein and binds to intrinsic factor (IF). The B12-IF complex binds to membrane receptors in the ileum.
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| What cells produce intrinsic factor (IF)? | show 🗑
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| show | Vitamin B12 is transported in the plasma by binding to transcobalamin II (TCII)
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| show | (1) Liver (2) Macrophages (3) Endothelial cells
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| What biochemical processes is cobalamin essential for? | show 🗑
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| show | Certain bacteria and animal muscle/organs
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| What is the most common cause of Vit B12 deficiency? | show 🗑
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| What conditions cause intrinsic factor deficiency? | show 🗑
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| (T or F) A poor diet is a very common cause of Vitamin B12 deficiency anemia. | show 🗑
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| show | Ileum
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| show | Pernicious Anemia
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| show | Methylmalonic acid and homocysteine are elevated.
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| show | Alcohol
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| What form is folate present in food? | show 🗑
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| show | It is a hypothesis that explains how B12 deficiency causes folate deficiency. Cobalamin is needed to convert N5-metyl-FH4 to FH4 (tetrahydrofolate). Colbalamin is a one carbon unit acceptor. In colabalmin deficiency, folate is trapped as N5-methyl-FH4.
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| What is the formate starvation hypothesis? | show 🗑
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| show | Green leafy vegetables, fruit, dairy products, yeast and animal livers.
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| What is the most common cause of folate deficiency? | show 🗑
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| What portion of the small bowel is folate absorbed? | show 🗑
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| What is the daily requirement of cobalamins? | show 🗑
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| show | 100 micrograms
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| How long does the body's storage of folate last? | show 🗑
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| show | The body stores a large amount that lasts for years.
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| What is a major complication of vitamin B12 deficiency? | show 🗑
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| show | No. Folate administration only correct hematologic abnormalites of Vitamin B12 deficiency, but not the neurological deficits.
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| What conditions can result in both folate and cobalamin deficiency? | show 🗑
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| What is the most likely cause of megaloblastic anemia if the Schillings test results for abnormally low, but normal after intrsinic factor administration? | show 🗑
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