[ppt]powerpoint presentation - welcome to my website :-) · web viewobjectives body stores and...
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Objectives • Body stores and daily requirements of vitamin B12
and folate• Absorption of vitamin B12 and folate from the gut• Causes of vitamin B12 and folate deficiency• Hematological consequences of vitamin B12 and
folate deficiency• Neurological sequelae of vitamin B12 deficiency• Diagnosis and management of megaloblastic
anemia• Diagnosis and management of Pernicious Anemia
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Requirements for Red Blood Cell Production
• Erythropoeitin• Proteins, required for globin synthesis• Iron • Vitamin B12 and folic acid• Vitamin B6 • Vitamin C • Thyroid hormones, estrogens and androgens
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Vitamin B 12 and Folate
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Macrocytic anemia with hypersegmented neutrophil
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Macro-ovalocyte in megaloblastic anemia
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Macro-ovalocyte in megaloblastic anemia
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Megaloblastic Anemia – Bone Marrow
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Bone marrow - megaloblasts
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Important for DNA synthesis, nervous tissue and fat metabolism in the liver
an intermediate of the citric acid cycle, porphyrin synthesis
(Heme synthesis)
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Absorption and transport of vitamin B12
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Absorption and transport of vitamin B12
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B12 /
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• Early graying of hair
• Blue eyes
Pernicious Anemia (PA)
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Pernicious Anemia
• Red beefy tongue
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Pernicious Anemia
• Vitiligo
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Normal Gastric atrophy
PA
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Atrophic Gastritis
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The patient was a 45 year old woman. She had a swollen tender tongue, parasthesias of both feet and hands, decreased proprioception and vibratory sensation, ataxia and leg weakness.
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Subacute Combined Degeneration of Spinal Cord
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CBC:
HbHctMCV MCHRDW WBC Plt
106 g/l32%125 f35.8 pg14.9%3.2100
(120-160)(35-46)(80-100)(27-33)(9-15)(4.8-10.8)(150-400
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Reticcount
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