Iron and B12 Deficiencies Flashcards

5871679370	Chemical name of vitamin B12	Cobalamin	0
5871679371	What protein helps B12 get absorbed in the ileum?	Intrinsic factor	1
5871679372	Where is IF secreted from?	Gastric parietal cells	2
5871679373	Which protein protects B12 from degradation in stomach?	Haptocorrin	3
5871679374	Where is Haptocorrin secreted from?	Exocrine glands	4
5871679375	Transporter of B12 into cells	Transcobalamin II	5
5871679376	Transporter of B12 into circulation	LRP-2	6
5871679377	In what foods is folate found?	Oranges, beans, legumes, fortified in wheat flour, collard greens, asparagus	7
5871679378	Where is Folate absorbed?	Jejunum	8
5871679379	Where is iron absorbed?	Duodenum	9
5871679380	In what foods is B12 found?	Red meat, poultry, milk, eggs, fish	10
5871679381	What aspect of metabolism is folate used for?	Transfer of 1-carbon units This is part of Nucleic acid synthesis and Cysteine, methionine, serine, glycine, histidine synthesis	11
5871679382	How much B12 does the body store and where?	5-10 years in the liver. So not commonly from diet, although strict vegans can be	12
5871679383	Pernicious anemia	Autoimmune destruction of gastric parietal cells	13
5871679384	What types of antibodies are associated with pernicious anemia?	Anti-IF and Anti-parietal cell	14
5871679385	Major causes of folate deficiency	Pregnancy, alcoholism Body doesn't store nearly as much as B12, so poor diet can get you. Not common in US though because of bread fortification	15
5871679386	In what group is B12 deficiency most prevalent?	Malnourished elderly	16
5871679387	Levels of which two other chemicals can indicate B12 deficiency?	High homocysteine High methylmalonic acid (These are intermediates upstream of B12 cofactor enzymes)	17
5871679388	B12 deficiency effect on blood cells (hematologic manifestations)	Macrocytosis of RBC's Hypersegmented neutrophils Megaloblastic anemia	18
5871679389	Megaloblastic anemia	Abnormal red blood cell precursors in the bone marrow - a symptom of B12 deficiency	19
5871679390	Other symptoms of B12 deficiency	Neuropsyhiatric symptoms *Combined sclerosis of spinal cord Fatigue Glossitis Cheilitis	20
5871679391	Glossitis	Beefy red tongue	21
5871679392	Cheilitis	Sore at corner of mouth	22
5871679393	Neuropsychiatric manifestations related to B12 deficiency	May be subtle, and can develop in isolation Gradual onset, progressive If left untreated, these are often NOT reversible	23
5871679394	Manifestation of of B12 deficiency in CNS	Loss of myelin in spinal cord	24
5871679395	Folate Deficiency	Neural Tube Defects Fatigue Macrocytosis Hypersegmented neutrophils Megaloblastic anemia	25
5871679396	Serum tests for B12 and folate	Less reliable for B12 deficiency	26
5871679397	Problem with folate serum test	One good hospital meal can normalize a patient's folate levels	27
5871679398	Laboratory diagnosis for B12 deficiency	Decreased B12 (not super reliable) Increased methylmalonic acid, homocysteine	28
5871679399	Laboratory diagnosis for folate deficiency	Decreased serum folate Increased homocysteine	29
5871679400	Which intermediate is higher in both B12 and folate deficiency	Homocysteine	30
5871679401	Potential pitfalls in diagnosing B12 deficiency	Functional B12 deficiency can occur at "normal" serum levels (Hcy and MMA still increased) Delayed diagnosis is common and can be dangerous (neuropsychiatric issues)	31
5871679402	Which compound is the Schilling test for?	B12	32
5871679403	How does the Schilling test work		33
5871679404	Patient management of B12 and folate deficiency: clinical pearls	If you suspect B12 or folate deficiency, check both Once the diagnosis of a deficiency is established, determine the cause	34
5871679405	B12 treatment	Parenteral B12 - intense loading followed by maintenance Oral B12	35
5871679406	Folate treatment	Oral folate daily	36
5871679407	Main takeaways regarding B12 and folate deficiency	Clinical and hematologic manifestations are diverse and may be subtle; anemia or macrocytosis may even be absent Neuropsychiatric perturbations may be IRREVERSIBLE if diagnosis/treatment is delayed Treatment is easy and inexpensive	37