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[blank_start]Macrocytosis[blank_end] = An increase in larger than normal red blood cells
[blank_start]Macrocytic Anaemia[blank_end] = A reduction in red blood cells, however the red blood cells have a larger than normal volume
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Macrocytic Anaemia
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Macrocytosis
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Mean Corpuscular Volume (MCV) is measured using which units?
[blank_start]Femtolitres[blank_end]
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The examples below showcase the difference between macrocytosis and macrocytic anaemia. Label them.
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Macrocytic Anaemia
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Macrocytosis
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TYPICAL EXAM QUESTION:
Normally sized red blood cells should be a similar size to [blank_start]the nucleus of a normal small lymphocyte[blank_end]
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the nucleus of a normal small lymphocyte
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a normally sized reticulocyte
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the nucleus of a normal small neutrophil
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At the point where a developing RBC leaves the bone marrow and loses its nucleus, it is called a [blank_start]reticulocyte[blank_end]
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As the erythropoietic pathway progresses, the overall cell size becomes [blank_start]smaller[blank_end] as the haemoglobin [blank_start]concentrates[blank_end]
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concentrates
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spreads out
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smaller
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larger
Frage 7
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At the first step of erythropoiesis, the cell is called a
Frage 8
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A red cell precursor (like a normoblast) which is abnormally large and has an immature nucleus is called a [blank_start]megaloblast[blank_end]
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TYPICAL EXAM QUESTION:
Which of the following aspects of erythropoiesis are defective in the development of a megaloblastic red blood cell?
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DNA Synthesis
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Nuclear Maturation
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RNA Synthesis
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Haemoglobin Synthesis
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Which of the following are preserved in megaloblastic red blood cells?
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DNA Synthesis
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Nuclear Maturation
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RNA Synthesis
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Haemoglobin Synthesis
Frage 11
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Macrocytic Anaemia is most commonly caused by deficiency of which Vitamins?
(2 Answers)
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Thiamine (B1)
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Niacin (B3)
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Pyridoxine (B6)
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Folate (B9)
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Cobalamin (B12)
Frage 12
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Silencing of genes occurs by a donor molecule adding a [blank_start]methyl[blank_end] group to a specific section of a DNA strand.
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The [blank_start]Folate[blank_end] Cycle is important for regulating the conversion of the [blank_start]U[blank_end] base of RNA to the [blank_start]T[blank_end] base of DNA. Disruption of this can cause nuclear maturation leading to macrocytic anaemia.
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T
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A
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C
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G
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U
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G
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C
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A
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Folate
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Methionine
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Cobalamin
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The [blank_start]Methionine[blank_end] Cycle (regulated by Vitamin [blank_start]B12[blank_end]) is important for the production of a donor molecule for DNA methylation, so that certain genes can be 'silenced'. Disruption of this cycle can cause defective nuclear maturation and thus macrocytic anaemia.
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Methionine
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Folate
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Cobalamin
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B12
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B9
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The Methionine Cycle regards the conversion of [blank_start]homocysteine[blank_end] to methionine via Vitamin B12 in order to produce a donor molecule for DNA strand methylation
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B12 Absorption System:
B12 enters stomach and is immediately bound by the [blank_start]R[blank_end]-binding protein
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B12 Absorption System:
Which protein is then released by stomach cells to bind to B12?
[blank_start]Intrinsic Factor[blank_end]
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B12 Absorption System:
Which type of cells release intrinsic factor from the stomach?
The gastric [blank_start]parietal[blank_end] cells
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B12 Absorption System:
B12 dissociates from R-binding protein and binds to Intrinsic Factor, before moving as this complex to the [blank_start]distal[blank_end] [blank_start]ileum[blank_end] where it dissociates from Intrinsic Factor and is absorbed via specific receptors.
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distal
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proximal
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ileum
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duodenum
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jejunum
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B12 Absorption System:
The receptors which absorb Vitamin B12 in the distal ileum after it has dissociated from Intrinsic Factor are called [blank_start]Cubulin[blank_end] Receptors
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A 67 year old man presents to you with chronic fatigue and nausea & vomiting. He has a past medical history of Vitiligo and Rheumatoid Arthritis. What is the most likely diagnosis for this man?
[blank_start]Pernicious Anaemia[blank_end]
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Anaemia caused by the autoimmune destruction of the gastric parietal cells is called [blank_start]Pernicious anaemia[blank_end]
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Pernicious Anaemia results in the deficiency of which protein needed for B12 absorption?
[blank_start]Intrinsic Factor[blank_end]
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Pernicious Anaemia should be treated with Vitamin B12 via which route of administration?
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Oral
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Subcutaneous
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Intravenous
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Intramuscular
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Sublingual
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Folate is typically absorbed in the ...
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Individuals abiding by a Vegan diet are more likely to become deficient in [blank_start]Vitamin B12[blank_end], due to the fact that it is commonly ascertained in our diets via animal meat.
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Which of the following conditions may result in B12/Folate deficiency?
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Crohn's Disease
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Ulcerative Colitis
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Coeliac Disease
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Gastric Ulcers
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Alcoholics are more likely to develop [blank_start]Folate[blank_end] deficiency
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Which of the following drug types can cause folate deficiency?
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Antipsychotics
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Anticonvulsants
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Antiarrhythmics
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Antidepressants
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Which three of the following symptoms are indicative of either a B12 or Folate deficiency?
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Sore tongue
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Weight loss
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Diarrhoea
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Headache
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Blurred vision
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Which deficiency anaemia can cause neurological problems such as dorsal column dysfunction and dementia?
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Folate deficiency
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B12 deficiency
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When all cells are low in number (RBCs, WBCs and Platelets) this is known as [blank_start]pancytopenia[blank_end]
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Another way of diagnosing macrocytic anaemia is via the discover of hypersegmented [blank_start]neutrophils[blank_end] on the blood film
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Neutrophils typically have [blank_start]3-5[blank_end] nuclear segments, if there are more than this then this is a potential sign of macrocytic anaemia
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Which two of the following autoantibodies are used in conjunction to diagnose B12-deficiency anaemia?
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Anti-IF
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Anti-GPC
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Anti-RBP
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Anti-CR
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Folic acid tablets for Folate-deficiency anaemia are typically [blank_start]5mg[blank_end] per day oral tablets.
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The recommendation for folic acid supplementation in pregnancy is [blank_start]0.4mg[blank_end] daily
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[blank_start]Spurious Macrocytosis[blank_end] = Red Blood Cell Volume is normal yet the MCV is high
[blank_start]Genuine Macrocytosis[blank_end] = Red Blood Cell Volume is abnormally large and MCV is high
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Genuine Macrocytosis
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Spurious Macrocytosis
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Which three of the following can cause spurious macrocytosis?
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Alcoholism
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Liver disease
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Hypothyroidism
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Hyperthyroidism
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Drug overdose
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Kidney Disease
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When red cells clump together causing the MCV machine to register them as 1 giant red cell, these clumps are known as [blank_start]cold agglutinins[blank_end]
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Patients with pernicious anaemia can appear mildly [blank_start]jaundiced[blank_end] due to intramedullary haemolysis