Notes in WS005 Vit B12 and folate deficiency

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Published	10/22/2024	Vitamin B12 (cobalamin) is water-soluble vitamin found in {{c1::animal-derived food}}Folate/folic acid (Vitamin B9) is in {{c1::greens, eggs, dairy, l…
Published	10/22/2024	Disruption of Vitamin B12 absorption --> Vit B12 deficiency:1. {{c1::parietal cells}} in stomach secrete {{c1::intrinsic factor }}2. {{c1::int…
Published	10/22/2024	Symptoms of {{c1::Vitamin B12 deficiency}}:atrophic glossitis (enlarged tongue)numbness + tingling of hands/feetheadaches
Published	10/22/2024	heme findings for B12 deficiency:MCV > {{c1::100 (macrocytic), megaloblastic changes}}mild {{c1::leukopenia}}mild {{c1::thrombocytopenia}}suppresse…
Published	10/22/2024	Diagnostic evaluation/confirmation for Vitamin B12 deficiency:measure {{c1::methylmalonic acid}} and {{c1::homocysteine}} levels
Published	10/22/2024	NOTE - nitric oxide use can increase risk of vitamin B12 deficiency
Published	10/22/2024	Vitamin B12 deficiency treatment:orally - for {{c1::dietary supplementation}}intravenous/intramuscular for (x3):- {{c1::pernicious anemia-GI abnormali…
Published	10/22/2024	Folate deficiency risk factors:dietary - {{c1::excessive ethanol use}}excess loss - {{c1::pregnancy}}meds - {{c1::bactrim}}
Published	10/22/2024	diagnosis/lab results for folate deficiencylow {{c1::serum folate}}maybe elevated {{c1::homocysteine}}normal {{c1::methylmalonic acid (this is indicat…
Published	10/22/2024	folate deficiency treatmentindefinite folic acid 1mg daily unless reversible cause (MT, psoriasis) is resolved and can discontinue laterensure no conc…
Published	10/22/2024	Building differential diagnosis for Case 1 (see handout):MCV < 80  (due to loss of {{c1::hemoglobin in RBCs}})indicates {{c1::microcytic}} ane…
Published	10/22/2024	Medical history to differentiate anemia:chronic anemia since birth + family history of anemia --> {{c1::thalassemia BC congenital }}inherited …
Published	10/22/2024	lab workup for microcytic anemia (x5):{{c1::serum irontotal iron binding capacity (rep free transferrin to bind iron)ferritin (rep body iron store)sol…
Published	10/22/2024	interpret lab results for microcytic anemia:
Published	10/22/2024	hallmarks of blood smear for this microcytic anemia:
Published	10/22/2024	workup and treatment for iron deficiency anemia: 1) most immediately, correct {{c1::iron deficiency}}:- {{c1::oral iron}}OR  -{{c1::IV …
Published	10/22/2024	megaloblastic anemia (macrocytic) in PB has {{c1::hypersegmented neutrophils}} and {{c1::macro-ovalocytic RBCs}}megaloblastic anemia (macrocytic) in B…
Published	10/22/2024	megaloblastic anemia (macrocytic) caused by (x3):{{c1::Vitamin B12 deficiencyFolate deficiencyBM abnormalities e.g., myelodysplastic syndrome}}non-meg…
Published	10/22/2024	what confirmatory lab test do you order for a diagnosis of Vitamin B12 deficiency?{{c1::methylmalonic acid (elevated) iron reticulocyte coun…
Published	10/22/2024	What can contribute to vitamin B12 deficiency?{{c1::dietary intake}} insufficient malabsorption due to (x4):{{c1::bowel resection}} {{c1::pe…
Published	10/22/2024	Iron absorption Liver hepcidin production (x4):increased by {{c1::inflammation trigger (cytokines)}}increased by {{c1::iron overload (too much bo…
Published	10/22/2024	Metabolite levels in vitamin B12 deficiency vs folate deficiency:in vitamin B12 deficiency:Vit B12 AKA cobalamin is cofactor for {{c1::methyltransfer}…
Published	10/22/2024	physiology of Vitamin B12 absorption{{c1::gastric}} protease releases B12/cobalamin from food --> cobalamin binds to {{c1::R-protein (transcobalami…
Published	10/22/2024	treatment for Vit B12 deficiency: if not urgent ({{c1::no neuro symptoms}}) --> {{c1::oral}} B12 supplementif severe deficiency (x3 - {{c1::ne…
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