Chapter 42- Vitamin B12 Deficiency Anemia Flashcards
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| 2304965643 | Pathophysiology of Vitamin B12 Deficiency Anemia | Causes anemia by inhibiting folic acid transport and reducing DNA synthesis in precursor cells; Precursor cells then undergo improper DNA synthesis and increase in size; Only a few are released from the bone marrow; Called megaloblastic or macrocytic anemia due to the large size of abnormal cells | 0 | |
| 2304976280 | Causes of Vitamin B12 Deficiency Anemia | Vegetarian diets or diets lacking dairy products; Anemia resulting from failure to absorb vitamin B12 (pernicious anemia) is caused by a deficiency of intrinsic factor, which is needed for intestinal absorption of vitamin B12 | 1 | |
| 2304983473 | Symptoms of Vitamin B12 Deficiency Anemia | Weight loss; N/V; Diarrhea; Paresthesias; Poor gait (affects myelin production on nerves); Abnormal balance; Pallor; Jaundice; Glossitis; Fatigue | 2 | |
| 2317697999 | Laboratory Assessment in Vitamin B12 Deficiency Anemia | Low: Hbg, Hct, RBC High: MCV and MCHC | 3 | |
| 2317706762 | Management of Vitamin B12 Deficiency Anemia | Focus is to increase intake of foods rich in vitamin B12 (animal proteins, eggs, and diary products); Vitamin supplements may be prescribed when anemia is severe; Vitamin B12 and folic acid levels are monitored | 4 | |
| 2317715331 | Shilling Test | Measures the presence of vitamin B12 in the urine after the patient is given an oral dose of radioactive B12; If patient does not absorb this due to pernicious anemia, the vitamin cannot get into the urine Patient drinks a radioactive B12 (cobalt 60) and also receives a radioactive IM dose as well; Nurse collects a 24 hour urine on the patient; Measure is taken of the radioactivity; If small amounts of radiation are excreted, a second stage test with radioactive B12 plus a capsule of oral intrinsic factor is done; If the patient has pernicious anemia, more B12 will be found in the second 24 hour urine test | 5 | |
| 2317736061 | Management with a high 1st Shilling's Test | Needs to increase dietary intake of vitamin B12 (animal sources, eggs, dairy products); Oral vitamin supplements | 6 | |
| 2317738925 | Management with a higher 2nd Shilling's Test | Vitamin B12 injections weekly, and then monthly; May change to nasal spray (CaloMist) replacement later to maintain vitamin levels but this is only used after the traditional injection methods have been tried first | 7 |