Folate and B12 Metabolism Deficiency Flashcards

3977954512	Vit B12	What was the historic "extrinsic factor"?	0
3977954513	Both are names for Vit B12	What is cobalamin and coenzyme B12?	1
3977954514	by microorganisms	Where is Vit B12 made?	2
3977954515	liver, glandular tissue, muscle, eggs, diary products, seafood	What are the dietary sources of Vit B12?	3
3977954516	stores 2-5 mg, and use 2-5 ug (0.1%)	What is the body storage level of Vit B12? How much is used daily?	4
3977954517	only in the terminal ileum	Where is B12 absorbed?	5
3977954518	(1) methyl transfer: methylation of homocystein to generate methionine. crucial for dividing tissues (like blood cell progenitors) (2) hydrogen transfer: generation of succinyl coA , crucial for myelin maintenance (explains neurological symptoms)	What two reactions does Vit B12 mediate?	6
3977954519	malabsorption: due to salivary gland dysfunction, loss of intrinsic factor (gastric), pancreatic disease, terminal ileum illness, IBS	What is the most frequent cause of B12 deficiency?	7
3977954520	yes, but it is very rare	Can B12 deficiency be caused by congenital deficiency states or inadequate ingestion?	8
3977954521	Gastric atrophy (no folds), megaloblastic anemia, neurological degeneration (demyelenation)	What are the 3 main clinical features of pernicious anemia?	9
3977954522	huge bone marrow cells - megaloblasts	What does the bone marrow of pernicious anemia pts look like?	10
3977954523	hemolysis because megaloblasts are dying in the bone marrow, thrombocytopenia, leukopenia,	What would a CBC and blood smear reveal with pernicious anemia?	11
3977954524	low serum B12 levels (<200) Peripheral and central nervous system disease methylmalonic acidemia elevated gastric pH	What clinical/lab findings are specific to Vit B12 deficiency?	12
3977954525	TC II B 12 -- is biologicallly useful! TCII can have a B12 analogue, though TCI can't be absorbed.	What's the difference between TC1 and TCII B12?	13
3977954526	intestinal bacterial overgrowth, liver disease, myeloid disorders	Under what conditions can serum B12 levels read falsely normal?	14
3977954527	pregnancy, lymphoid disorders, ageing, racial differences	Under what conditions can serum B12 be falsely low?	15
3977954528	MMA (methylmalonic acid)	What is the most reliable marker for Vit B12 deficiency?	16
3977954529	B12 injections monthly for a lifetime	What is the therapy for Vit B12 deficiency?	17
3977954530	true	T/F: there can be lots of variation in the presence of neurologic manifestations with Vit B12 deficiency.	18
3977954531	an anemia identical to B12 deficiency but not associated with atrophic gastritis or neurologic disease	What is Tropical Macrocytic anemia?	19
3977954532	higher plants and microorganisms	What synthesizes folic acid?	20
3977954533	store 5 mg and use about 50 ug. Both folate and Vit B12 are stored in the liver	How much folic acid do you store? How much do you use daily? Where is folate stored?	21
3981067317	absorbed in the proximal jejunum and throughout the small intestine.	Where is folic acid absorbed?	22
3977954534	leafy greens, asparagus, broccoli, spinach, liver, kidney, fruits, mushrooms	What are some dietary sources of folate?	23
3977954535	dietary folate is mostly in methylated form. it is deconjugated in the intestine before absorption. It is reduced to N5-methyl tetrahydrofolate (FH4), and once in the tissues, it is polyglutamated	How folic acid transformed, from the time it enters the body?	24
3977954536	Vit B12 is there to allow methioniine syntase to convert 5-methyl TH4 folate to TH4 folate	How do folate and Vit B12 interface?	25
3977954537	poor DNA synthesis. Get uracil misincorporation into DNA, leading to DNA strand breaks and cell cycle arrest... that is why you get macrocytosis.	What are the consequences of folate deficiencies?	26
3977954538	macrocytic, because of problem with DNA synthesis, and those cells being stuck in that phase of the cell cycle	Is folate deficiency anemia micro or macrocytic?	27
3977954539	false! neurological disorders result from B12, not folate, deficiencies	T/F: both folate and B12 deficiency result in systemic disease and neuropathy	28
3977954540	inadequate ingestion (very common), inadequate absorption, metabolic block in utilization, increased requirement	What are the causes of folate deficiency?	29
3977954541	Short term : serum folic acid levels (< 3 ng/mL is bad) Long term/chronic: red cell folate levels (<135 ng/mL is bad)	How do you assess short term folate levels? Long term folate levels?	30
3977954542	high levels of homocysteine... but how elevated matters (normal is 4-12... for folate deficiency its 15-50, and for B12 deficiency its 20 - 241)	Besides folate levels, what other metabolite can suggest folate deficiency?	31
3977954543	both	B12 or folate deficiency: megaloblastic anemia?	32
3977954544	B12	B12 or folate deficiency: combined system degeneration?	33
3977954545	B12 - rare; folate - common	B12 or folate deficiency: poor diet associated with deficiency state?	34
3977954546	folate	B12 or folate deficiency: other dietary deficiencies present?	35
3977954547	B12: muscle, liver, milk, eggs Folate: liver, leafy greens	B12 or folate deficiency: dietary source?	36
3977954548	both	B12 or folate deficiency: deficiency induces high homocystein?	37
3977954549	B12: terminal ileum folate: all small bowel	B12 or folate deficiency: site of absorption?	38
3977954550	B12	B12 or folate deficiency: intrinsic factor required?	39
3977954551	B12 only	B12 or folate deficiency: deficiency associated with high methylmalonic?	40
3981108441	True	True of False: There is a mild association with homocysteine and vascular disease in the normal population	41
3981109904	D	Folate deficiency is associated with: A. Combined system degeneration B. Aplastic anemia C. B12 malabsorption D. Neural tube defects	42
3982307910	True	True or False: B12 deficiency produces increased MMA and homocystein while folate deficiency only shows an increase in homocystein.	43