Macrocytosis & Macrocytic Anaemia

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❌ = An increase in larger than normal red blood cells
❌ = A reduction in red blood cells, however the red blood cells have a larger than normal volume

Macrocytic Anaemia

Macrocytosis

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Mean Corpuscular Volume (MCV) is measured using which units?

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The examples below showcase the difference between macrocytosis and macrocytic anaemia. Label them.

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TYPICAL EXAM QUESTION:
Normally sized red blood cells should be a similar size to ( the nucleus of a normal small lymphocyte, a normally sized reticulocyte, 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

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As the erythropoietic pathway progresses, the overall cell size becomes ( smaller, larger ) as the haemoglobin ( concentrates, spreads out )

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At the first step of erythropoiesis, the cell is called a

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A red cell precursor (like a normoblast) which is abnormally large and has an immature nucleus is called a

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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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Which of the following are preserved in megaloblastic red blood cells?

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Macrocytic Anaemia is most commonly caused by deficiency of which Vitamins?
(2 Answers)

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Silencing of genes occurs by a donor molecule adding a group to a specific section of a DNA strand.

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The ( Folate, Methionine, Cobalamin ) Cycle is important for regulating the conversion of the ( U, G, C, A ) base of RNA to the ( T, A, C, G ) base of DNA. Disruption of this can cause nuclear maturation leading to macrocytic anaemia.

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The ( Methionine, Folate, Cobalamin ) Cycle (regulated by Vitamin ( B12, B9 )) 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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The Methionine Cycle regards the conversion of 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 -binding protein

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B12 Absorption System:
Which protein is then released by stomach cells to bind to B12?

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B12 Absorption System:
Which type of cells release intrinsic factor from the stomach?
The gastric 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 ( distal, proximal ) ( ileum, duodenum, jejunum ) where it dissociates from Intrinsic Factor and is absorbed via specific receptors.

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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 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?

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Anaemia caused by the autoimmune destruction of the gastric parietal cells is called

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Pernicious Anaemia results in the deficiency of which protein needed for B12 absorption?

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Pernicious Anaemia should be treated with Vitamin B12 via which route of administration?

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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 ( Vitamin B12, Folate ), 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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Alcoholics are more likely to develop ( Folate, Vitamin B12 ) deficiency

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Which of the following drug types can cause folate deficiency?

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Which three of the following symptoms are indicative of either a B12 or Folate deficiency?

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Which deficiency anaemia can cause neurological problems such as dorsal column dysfunction and dementia?

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When all cells are low in number (RBCs, WBCs and Platelets) this is known as

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Another way of diagnosing macrocytic anaemia is via the discover of hypersegmented on the blood film

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Neutrophils typically have ( 3-5, 2-3, 4-7 ) 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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Folic acid tablets for Folate-deficiency anaemia are typically ( 5mg, 0.5mg, 15mg, 50mg ) per day oral tablets.

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The recommendation for folic acid supplementation in pregnancy is ( 0.4mg, 4mg, 14mg, 40mg ) daily

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❌ = Red Blood Cell Volume is normal yet the MCV is high
❌ = Red Blood Cell Volume is abnormally large and MCV is high

Genuine Macrocytosis

Spurious Macrocytosis

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Which three of the following can cause spurious macrocytosis?

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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

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Macrocytosis & Macrocytic Anaemia lecture given on tuesday of week 1

Macrocytosis & Macrocytic Anaemia

❌ = An increase in larger than normal red blood cells ❌ = A reduction in red blood cells, however the red blood cells have a larger than normal volume

Mean Corpuscular Volume (MCV) is measured using which units?

The examples below showcase the difference between macrocytosis and macrocytic anaemia. Label them.

At the point where a developing RBC leaves the bone marrow and loses its nucleus, it is called a

As the erythropoietic pathway progresses, the overall cell size becomes smaller larger( smaller, larger ) as the haemoglobin concentrates spreads out( concentrates, spreads out )

At the first step of erythropoiesis, the cell is called a

A red cell precursor (like a normoblast) which is abnormally large and has an immature nucleus is called a

TYPICAL EXAM QUESTION: Which of the following aspects of erythropoiesis are defective in the development of a megaloblastic red blood cell?

Which of the following are preserved in megaloblastic red blood cells?

Macrocytic Anaemia is most commonly caused by deficiency of which Vitamins? (2 Answers)

Silencing of genes occurs by a donor molecule adding a group to a specific section of a DNA strand.

The Folate Methionine Cobalamin( Folate, Methionine, Cobalamin ) Cycle is important for regulating the conversion of the U G C A( U, G, C, A ) base of RNA to the T A C G( T, A, C, G ) base of DNA. Disruption of this can cause nuclear maturation leading to macrocytic anaemia.

The Methionine Cycle regards the conversion of to methionine via Vitamin B12 in order to produce a donor molecule for DNA strand methylation

B12 Absorption System: B12 enters stomach and is immediately bound by the -binding protein

B12 Absorption System: Which protein is then released by stomach cells to bind to B12?

B12 Absorption System: Which type of cells release intrinsic factor from the stomach? The gastric cells

B12 Absorption System: B12 dissociates from R-binding protein and binds to Intrinsic Factor, before moving as this complex to the distal proximal( distal, proximal ) ileum duodenum jejunum( ileum, duodenum, jejunum ) where it dissociates from Intrinsic Factor and is absorbed via specific receptors.

B12 Absorption System: The receptors which absorb Vitamin B12 in the distal ileum after it has dissociated from Intrinsic Factor are called Receptors

❌ = An increase in larger than normal red blood cells
❌ = A reduction in red blood cells, however the red blood cells have a larger than normal volume

As the erythropoietic pathway progresses, the overall cell size becomes ( smaller, larger ) as the haemoglobin ( concentrates, spreads out )

TYPICAL EXAM QUESTION:
Which of the following aspects of erythropoiesis are defective in the development of a megaloblastic red blood cell?

Macrocytic Anaemia is most commonly caused by deficiency of which Vitamins?
(2 Answers)

The ( Folate, Methionine, Cobalamin ) Cycle is important for regulating the conversion of the ( U, G, C, A ) base of RNA to the ( T, A, C, G ) base of DNA. Disruption of this can cause nuclear maturation leading to macrocytic anaemia.

B12 Absorption System:
B12 enters stomach and is immediately bound by the -binding protein

B12 Absorption System:
Which protein is then released by stomach cells to bind to B12?

B12 Absorption System:
Which type of cells release intrinsic factor from the stomach?
The gastric cells

B12 Absorption System:
B12 dissociates from R-binding protein and binds to Intrinsic Factor, before moving as this complex to the ( distal, proximal ) ( ileum, duodenum, jejunum ) where it dissociates from Intrinsic Factor and is absorbed via specific receptors.

B12 Absorption System:
The receptors which absorb Vitamin B12 in the distal ileum after it has dissociated from Intrinsic Factor are called Receptors

Individuals abiding by a Vegan diet are more likely to become deficient in ( Vitamin B12, Folate ), due to the fact that it is commonly ascertained in our diets via animal meat.

Alcoholics are more likely to develop ( Folate, Vitamin B12 ) deficiency

Neutrophils typically have ( 3-5, 2-3, 4-7 ) nuclear segments, if there are more than this then this is a potential sign of macrocytic anaemia

Folic acid tablets for Folate-deficiency anaemia are typically ( 5mg, 0.5mg, 15mg, 50mg ) per day oral tablets.

The recommendation for folic acid supplementation in pregnancy is ( 0.4mg, 4mg, 14mg, 40mg ) daily