B12 deficiency and pernicious anaemia Flashcards
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| 4907075673 | Where is it found B12 | Meat, fish, dairy product, not in plants | 0 | |
| 4907093000 | Pathophysiology | Binds to intrinsic factor in the stomach and then absorbed as a complex in terminal ileum | 1 | |
| 4907095291 | Causes of deficiency | Dietary (vegan) Malabsorption - stomach (lack of intrinsic factor) - pernicious anaemia, post gastrectomy, terminal ileum - ileal resection, crohn's disease Congenital metabolic errors | 2 | |
| 4907110073 | Signs and symptoms | General - anaemia, mild jaundice (haemolysis), glossitis, angular cheilosis Neuropsychiatric - irritability, depression psychosis, dementia Neurological - paraesthesia, peripheral neuropathy | 3 | |
| 4907242515 | Subacute combined degeneration of spinal cord | Onset is insidious with peripheral neuropathy Symmetrical posterior colmn loss, causing sensory and LMN signs Symmetrical corticospinal tract loss causing motor and UMN signs Joint position and vibration sense are first affected leading to ataxia followed by stiffness and weakness Classic triad - extensor plantars, absent knee jerks, absent ankle jerks Pain and temperature sensation intact as spinothalamic tract preserved | 4 | |
| 4907475394 | Pernicious anaemia is | an autoimmune atrophic gastritis leading to achlorhydria and lack of gastric intrinsic factor secretion | 5 | |
| 4907488095 | Other associations of pernicious anaemia | Age >40 Other autoimmune disease, thyroid disease, vitiligo Stomach cancer is 3 fold more common in pernicious anaemia | 6 | |
| 4907489868 | Tests | FBC, Serum B12 For pernicious anaemia Parietal cell antibodies Intrinsic factor antibodies (specific but not sensitive) | 7 | |
| 4907496163 | Treatment | If issue is malabsorption then IM B12 If issue is dietary, then oral B12 If less than 40 then PA not likely, look into other causes Watch for hypokalaemia as treatment becomes established Additional iron may be needed Recovery from peripheral neuropathy takes months | 8 |