Megalobastic anemias (week 4)

Megalobastic anemia is characterized by deficient _______ _______ which can be caused by impaired ______ synthesis

nuclear maturation, DNA

DNA synthesis impairment can be caused by either a _______ or ______ deficiency

B12,folate

DNA synthesis impairment can lead to_______ with maturation arrest resulting in early destruction aka ______

myeloblasts, apoptosis

because of the decrease in mature red cells oxygen is _______ along with _____

decreased, Hgb

along with ineffective erythropoiesis there is also ineffective _________ and ________

granulopoiesis, thrombopoiesis

the bone marrow of a megaloblastic anemia patient will be __________

hypercellular

nuclear cytoplasm asynchrony:

typical finding in MA, cytoplasm is more mature than nucleus

Megaloblastic changes will effect the WBCs leading to the presence of large _____ and the characteristic _________ ______

bands, hypersegmented neutrophils

B12 and folate impairment will effect the DNA synthesis for _______ ______ ______

all cell line s

what are common things you would find on a megaloblastic anemia patient's smear?

macrocytes, macro-ovalocytes, hyper-segmented neutrophils, basophilic stippling, and mild pancytopenia

Howell jolly bodies come from ______ ________ in the cell

leftover DNA

the normal amount of B12 we should ingest is ____ mg for adults

2.4

B12 can also be called:

Cobalamin

B12 is essential for DNA syntheisis and _______ _________

neurological function

when vitamin b12 gets released from our food into our stomachs it has to be bound to HC aka ______

haptocorrin

If vitamin B12 is not bound to haptocorrin then it will be __________ in the stomach

denatured

Haptocorrin will carry B12 and they will bind to __________ of IF which is made in the ______

intrinsic factor, stomach

B12 bound to IF will get absorbed in the __________ via enterocytes

ileum

ileum is

third part of the small intestine

folate a __________ are needed for the absorbtion and metabolism of _______ _______

Hemocystine, folic acid

vegans a vegetarians are commonly deficient in ____ ______ causing a ________ in plasma folate

folic acid, increase

the main cause of B12 deficiency is a problem with _______

absorbtion

the main anemia associated with B12 deficiency is __________

Pericious anemia

_____________ abnormalities are common in megaloblastic anemias

nurological

Gastrectomy patients are at risk of megaloblastic anemias because the _________ _______ _______ are removed

IF producing cells

in blind loop syndrome the patients IF is competing with a bacteria for ______

B12

why can pancreatic disease lead to the development of megaloblastic anemias?

the patient will not produce enough enzymes needed to digest B12's carrying protein haptocorrin

folic acid is also known as ______

B9

folic acid is soluble in _____ and often found in _______ _________ __________

water, leafy green vegetables

the recommended amount of folic acid we absorb is _____ - _____ mcg a day

50,100

if a mother is pregnant or lactating, her need for folic acid will ________

increase

if you don't get enough folic acid during pregnancy your baby could be born with _____ ______ defects like spina bifida or brain damage

neural tube

dietary folic acid is a form of ___________ acid

polyglutamic

polygultamic acid is acted on by the enzyme _________ ________ which is found in epithelial cells

folate dehydrogenase

after being acted on polyglutamic acid will then become __________ acid with is reduced and methylated to ___________

Monoglutamic, CH3THF

CH3THF

Methyltetrahydrafolate

folic acid deficiency can be caused by _____, malabsorbtion or _______ use

diet, drug

serum B12 and folate levels in red cells will ____ in a folate or B12 ______

decrease, deficiency

to treat B12 deficency its common for the patients to be on ________ _________ ________

lifelong vitamin therapy

a positive responce to treatment for megaloblastic patients is a increase in ___________ _____

retic count

normoblastic anemias have MCV roughly around:

100

megaloblastic anemias have a MCV around:

115

macrocytic anemia is commonly from________ disease or _______

liver, alcoholism

Orotic aciduria:

increased excretion of orotic acid in urine

Lesch-Nyhan syndrome

disorder of pyrimidine metabolism