Vitamin B 12 Deficiency Flashcards

3272883604	anemia is defined as an abnormally low number of circulating ____ or low concentration of ____. this results in diminished oxygen carrying capacity of the blood.	RBC hemoglobin	0
3272685002	what does B 12 make?	RBC	1
3272887417	vitamin b 12 is essential for the synthesis of ___	DNA	2
3272740391	what type of anemia is vitamin b 12 deficiency?	macrocytic and hypochromic	3
3272687240	Vitamin B 12 deficency is an anemia which means you do not have enough RBC. What does this cause?	pt will feel weak and tired	4
3272689240	deficient amounts of vitamin B 12 will cause ____ and _____ _____ injury	anemia nervous system	5
3272690245	what can vitamin B 12 trigger?	pernicious anemia	6
3272691667	Name 3 chief complaints of a pt with vitamin B 12 deficiency	problems talking and concentrating memory issues numbness in legs and trouble walking	7
3272693821	what is the history and present illness of a patient with vitamin b12 deficiency?	-pallor and fatigue -difficulty concentrating and short term memory loss -bilateral lower extremity numbness -gait problems -tingling in hands and feet -peripheral neuropathy	8
3272701545	difficulty with gait shows that there could be a problem with the ____	cerebellum	9
3272792748	do patients with vitamin b 12 deficiency typically have a problem with their cerebellum?	NO cerebellar problems is a differential diagnosis	10
3272703572	Cerebellar symptoms show that the vitamin B 12 deficiency has progressed. How does the disease progress?	from peripheral to inward	11
3272706217	patient was an alcoholic and a drug abuser. alcohol can cause the stomach lining to become aggregated. What can this cause?	decrease in vitamin b 12 absorption and folic acid absorption	12
3272711847	Patients mother developed bacterial thyroiditis. Is bacterial thyroiditis a risk factor for vitamin B 12 deficiency?	YES	13
3272713582	excessive alcohol and ____ use is a risk factor	cocaine	14
3272714745	long history of ____ _____ is a risk factor. patient is not taking in enough vitamin b 12	poor nutrition	15
3272716422	Patients who are vegetarians and vegans lack what?	higher risk for lacking vitamin b 12 and folic acid	16
3272717591	meat supplies you with what?	vitamin b 12	17
3272717592	vegetables supply you with what?	folic acid	18
3272720451	what can be an initial sign of a patient with vitamin b 12 deficiency?	burning tongue (atrophic gloittis)	19
3272723233	if your stomach lining is destroyed you may not be able to absorb ____ ____ which leads to malabsorption of it b 12	intrinsic factor	20
3272725761	what drug suppresses the production of stomach acid which will lead to the malabsorption of vit b 12?	OTC famotidine (treats heartburn)	21
3272727582	patient who has a vitamin b 12 deficiency can present with	-malnourished -cognitive impairments -restless	22
3272730066	patients BMI will most likely be ______. why?	underweight pt will typically be malnourished	23
3272732330	pt's vital signs show a wide pulse pressure. What is this indicitive of?	-anemia -thyrotoxicosis	24
3272733588	what can a widened pulse pressure eventually cause?	heart murmur	25
3272736731	what will the patients skin look like?	pale with slight jaundice. patient is pale b/c they are deficient in RBC	26
3272745247	what do the patients eyes present with? ___ ___	sclera icterus	27
3272746531	what is sclera icterus and what is it indicitive of?	jaudice in the eyes billiruben has crossed the BBB	28
3272749938	what will the patients tongue look like?	beefy red tongue with glossitis. tongue will burn	29
3272752174	_____ of the mucous membranes. This is because of decreased RBC	pallor	30
3272772037	why is there significant discomfort in the neck?	spread to the spinal cord?	31
3272773777	why is the systolic border best heard at the right sternal border?	because the Hct is less than 20%	32
3272774541	why is there a murmur present?	increased pumping b/c of anemia	33
3272775181	what else can cause the murmur?	cocaine. major affect of cocaine is vasoconstriction. this can cause angia and vasoconstriction of the brain	34
3272778270	pts mental status will show	slow response time. mild loss of mental status	35
3272780927	why is there a mild loss of mental status?	damage to the myelin sheath	36
3272841492	vitamin b 12 plays an important role in developing the ____ _____	myelin sheath	37
3272780928	what five areas does the mental status test for?	orientation, registration, attention, calculation, recall/language	38
3272782448	motor exam shows _____ results	mild results. 4/5	39
3272783624	why are there absent reflexes of the ankles?	disease of the spinal cord. there is damage to the myelin sheath	40
3272784603	damage to the spinal cord and myelin sheath will cause what?	paraesthisia to the distal extremities	41
3272787173	will the patient have a positive babinski?	YES	42
3272789535	because of the damage to the myelin sheath the sensory and motor pathways are messed up because of the damage to the spinal cord	ANSWER TO ALL THINGS	43
3272790532	what does the romberg test, test for?	proprioreception	44
3272796119	pt will present with: -numb feet -slapping, pins and needles -foot drop -nerve damage -sensory loss		45
3272797238	LAB STUDIES	-Hb LOW -Hct LOW -RBC LOW -platelets LOW -WBC LOW -Reticulocytes LOW -MCV HIGH -MCH HIGH -Vit B 12 LOW -Folic Acid LOW -T billiruben HIGH -Billiruben indirect HIGH -Alb LOW -T protein LOW -LDL HIGH -MMA HIGH -homocystine HIGH	46
3272805398	Why is the Hb and Hct low?	poor nutrition and alcohol abuse cannot absorb the vitamin b 12 based off of the serum antibodies	47
3272809074	The reticulocytes are low because not enough RBC being _____. what does this mean?	produced Aplastic Anemia	48
3272809965	MCV is high which indicates	Macrocytic anemia	49
3272810826	MCH is high which means	Macrocytic blood vessels that have a higher concentration of hemoglobin on each RBC	50
3272812473	why is the billiruben high?	b/c of the break down of hemoglobin	51
3272816001	your body produces billiruben when it breaks down ____. Macrocytic cells have increased hemoglobin so when they break down the billiruben levels increase.	hemoglobin	52
3272817961	Albumin is made in the ____	liver	53
3272817962	the albumin is low because	-poor nutriton -decreased stomach function	54
3272819992	LDL is high is this related to the vitamin b 12 deficiency?	No, poor lifestyle habits	55
3272820726	What is MMA	Methylmalonic Acid -specific test for vitamin b 12	56
3272822786	RBC are an abnormal size	anisocytosis	57
3272823157	RBC are an abnormal shape	poikliocytosis	58
3272826764	____ ____ are indicitive of megablastic anemia of either vitamin b 12 deficency or folic acid deficiency. In megablastic anemia you have 6-8 lobes	hypersegmented neutrophils	59
3272828414	pertinent negative that the serum antibodies showed ____ ____ and ____ ___	intrinsic factor parietal cells	60
3272830076	without ___ ___ vitamin b 12 cannot be absorbed	intrinsic factor	61
3272830634	vitamin b 12 deficiency can cause ____ _____	perncious anemia	62
3272834288	the patient was negative for antibodies meaning he has intrinsic factor. Does this mean that the patient has pernicious anemia?	NOOOOO	63
3272836152	If the patient is positive for intrinsic factor and parietal cells does this mean that the patient has pernicious anemia?	YES	64
3272843263	ID 3 major risk factors that contributed to vitamin b 12 deficiency in this patient	-alcohol -poor nutrition -mom having hypothyroid	65
3272845528	name 8 symptoms that are consistent with the diagnosis of vitamin b 12 deficiency	- difficulty concentratining -difficulty expressing -problems with memory -numbness in the periphery -trouble walking -unsteady in the dark -shooting pain in the neck (damage to myelin sheath) -poor nutrition -fatigue	66
3272849019	ID 15 objective signs that correlate with the diagnosis of vitamin b 12 deficiency	- response time slow -pallor -mild jaundice -glossitis -diminshed sensations -slap foot - 4/5 on motor exam -positive babinski -absent ankle reflex -no temperature sensation -diminished pin prick sensation - loss of vibration - cannot stand with eyes closed (romberg test)	67
3272853166	ID lab findings correlating with vitamin b 12 deficiency	- Low hg, hit, platelets, rbc, wbc, reticulocytes, vitamin b 12, folic acid -high MCV, MCH, billiruben indirect	68
3272856686	is the patients renal function normal or abnormal?	normal because patients Bun and creatitin were normal	69
3272857606	is the patients hepatic function normal?	abnormal because of high billiruben and low albumin	70
3272859438	is the patients lipid panel normal?	no, HIGH LDL	71
3272860308	does this patient have pernicious anemia?	no because he has negative ID and parietal cell antibodies	72
3272862234	what type of anemia does this patient have? -megaloblastic anemia -neurological abnormalities -none of the above	megablastic anemia	73
3272865622	medical term for "severe neck pain shooting down the back into the arms" _____ _____. what does this indicate?	cervical reticulopathy severe damage to the myelin sheath affecting the neck and the spinal cord	74
3272869830	why does this patient has a slap foot?	because of weakness and paralysis of the extremities due to the loss of the myelin sheath	75
3272871731	why is the significance of the romberg test in this patient?	tests the patients proprioreception, shows the patient has ataxia	76
3272873942	need to differentiate vitamin b 12 deficiency from what?	folic acid deficiency	77
3272875389	how do you treat this patient?	-IM vitamin b 12 injections and potassium -rehab for drug/alcohol abuse	78
3272894982	READING		79
3272895637	prevalence of vitamin b 12 deficiency increase with ____ and _____	age use of gastric acid blocking agents	80
3272897830	human body stores _____ years worth of vitamin b 12. Symptoms of a deficiency will manifest in 3 years	3-5 years	81
3272898542	infants and children show symptoms more ___	rapidly	82
3272901698	-anorexia with weight loss -burning or soreness of the tongue with changes in taste -N/V -neurological symptoms -paraesthisa -symptoms can mimic Alzhemiers -psychotic manifestations -spinal cord damage	symptoms associated with vit b 12 deficiency	83
3272907487	-strict vegetarian diet -chronic alcoholism	dietary insufficiency of vitamin b 12	84
3272910042	-surgical removal of stomach -chronic gastritis -use of histamine 2 blocking drugs or PPI -chronic pancreatitis	insufficent stomach acid or pancreatic enzymes to serape b 12 from ingested animal proteins or b12 binding proteins	85
3272914222	-IF deficiency (pernicious anemia) -removal of terminal ileum -chrons -celiac -lakefish tapeworms -medications such as: cholestyramine, neomycin, metoformin, phenoformin, chlorine	impaired absorption of vitamin b 12	86
3272916214	cognetial deficiency of plasma protein carrier transcoblamin II	abnormality in the plasma transport of vitamin b 12	87
3272918249	absence of intrinsic factor is the most common cause of vitamin b 12 deficiency in the US		88
3272921074	major risk factors of vit b 12 deficiency	- positive FH of pernicious anemia -scandinavian or celtic descent -neuroendocrine disease, type 1 diabetes, addison disease, graves disease, hasimotis thyroiditis	89
3272927272	"any process that impairs the ingestion, separation, absorption, plasma transport or transfer into cells of B12 may result in the clinical manifestation of a bit b12 deficiency*		90
3272932394	_____ _____ is characterized by an infiltration of lymphocytes within the walls of the stomach that is associated with degeneration of parietal cells and their replacement of goblet cells. This is known as intestinal metaplasia	perncious anemia	91
3272936852	bone marrow biopsy will show: -marked red blood cell hypercellularity -megaloblastic in red and white blood cell lines		92
3272937406	+ intrinsic factor and parietal cells indicate	PERNCIOUS ANEMIA	93
3272938455	lymphocytes will appear in the walls of the ____ in pernicious anemia	stomach	94
3272943281	what are reticulocytes?	immature blood cell without a nucleus	95
3272944799	why is it reasonable to test the serum folic acid concentration in a patient who is suspected of having it b 12 deficiency	present with similar lab findings need to differentiate	96
3272961905	what is alchlorhydira?	production of hydrochloric acid in gastric secretions is low in the stomach	97
3272963953	why is achyloridia reasonable to find in patients with pernicious anemia?	because there is a commonly problems with the stomach lining in patients because of improper neutrition and alcohol	98
3272967508	If the father of an unborn child has a single defective gene/mutation for transcobalamin II deficiency and the mother has two normal genes, what is the probability that their unborn child will be transcobalamin II deficient?		99
3272968141	If both the father and mother of an unborn child each have a single defective gene/mutation for transcobalamin II deficiency, what is the proba- bility that their unborn child will be transcobalamin II deficient?		100
3272968142	Why is it reasonable to find lymphocytes in the walls of the stomach in patients with pernicious anemia?		101
3272971712	type 1 diabetes mellitus	lack of serum insulin	102
3272971713	addison disease	decrease serum cortisol	103
3272972154	graves disease	increase serum thyroxine	104
3272972155	hashimotos thyroiditis	decrease serum thyroxine	105
3272974419	persistent aberrant beliefs or perceptions held invio- lable by a person despite evidence that refutes them	delusion	106
3272975765	abnormal condition characterized by an elaborate, sus- picious system of thinking that is usually centered on one major theme, such as an unfaithful spouse, being poisoned, or being watched by outer space aliens	paranoia	107
3272976201	abnormal sensory perceptions that can occur in any of the senses, do not result from an external stimulus, and occur in the waking state	hallucinations	108
3272779189	why is there a mild loss of mental status?	damage to the myelin sheath	109