Megaloblastic anemias are characterized by morphologic changes
resulting from pathologic impairment of DNA synthesis. Most often,
these anemias result from deficiencies of folate and/or vitamin B12.
When evaluating a patient with megaloblastic anemia, it is crucial to
determine which of these vitamins is actually deficient and to define
the disease state responsible for the deficiency.
- List the causes of macrocytic anemia.
- Describe the morphologic hallmarks of megaloblastic erythropoiesis and granulopoiesis in the blood and bone marrow.
the biochemical pathway which explains how folate and vitamin B12
deficiency ultimately impair thymidylate synthesis, and methionine and
fatty acid metabolism.
- Identify the dietary sources of
vitamin B12 and folate and to describe their associated sites and
mechanisms of absorption, means of transport, and duration and location
- Describe the differences between vitamin B12 deficiency and folate deficiency with respect to:
- their most common causes
- time to development of the clinical deficiency state
- presence of neurologic and neuropsychiatric abnormalities
- Describe the clinical, laboratory and autoimmune findings associated with pernicious anemia.
- List the appropriate therapies for B12 deficiency and folate deficiency.
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