Science Quiz / CSIM - Megaloblastic anaemias

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Can you name the Megaloblastic anaemias

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In megaloblastic anaemias, impaired __ synthesis results in the appearance of megaloblasts in the marrow
These are abnormal __
They are large cells, containing large abnormal nuclei with finely dispersed __
Anaemia occurs because megaloblasts are removed by bone marrow __ (ineffective erythropoiesis)
Megaloblastic anaemia is usually due to deficiency of __
Both act as __ in the pathway of DNA synthesis
Haematological findings include a __ anaemia
__ of neutrophil nuclei
Megaloblasts seen on bone marrow __
B12 deficiency: B12 consists of __ bound to a __ or __ group
It is found only in foods of __
And is not affected by __
Absorption occurs in the __
After combining with __ secreted from gastric parietal cells
Transport within the body is with the plasma-binding protein __
It is stored in the __
Body stores are large at __
The daily rate of loss in urine & faeces is small relative to daily requiremets of __
Therefore it takes more than __ after the onset of the cause of B12 deficiency for anaemia to develop
Causes of B12 deficiency include: Dietary, e.g. due to __ (rare)
__ deficiency, e.g. congenital postgastrectomy or due to pernicious aneamia
__ e.g. due to diseases of the terminal ileum such as Crohn's
Blind loop or __ in the small bowel that breed bacteria that utilise B12
HintAnswer
Pernicious anemia: __ is the most common cause of B12 deficiency in adults
Autoantibodies detected against both the __ & __ are detectable in the serum & gastric juice of most patients
Damage to the parietal cells results in failure of IF secretion & __ absorption
__ is an accompanying feature
It is associated with __ disease
And patients are at an increased risk of __
Clinical features include a __ colour to the skin (severe), due to a combination of pallow & jaundice
Also there can be __
Folate deficiency: folates are derived from __
They are found in foods, __ vegetables & liver
And are destroyed by __
Absorption takes place in the __ & __
Folate is stored in the __
Unlike B12, folate stones are small (__)
And daily losses are __ than daily requirement ~(100-200ug)
Therefore a megaloblastic anaemia develops __ after the onset of folate deficiency
Causes include: decreased __ e.g. due to poor diet
Decreased __ e.g. due to coeliac disease
Increased __ due to rapid cell multiplication, e.g. pregnancy, prematurity, malignancy or haemolytic anaemia
Increased __ e.g. due to dialysis
Drugs, e.g. __
Clinical features are similar to B12 deficiency but without the __ abnormalities

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