Page 296 - Clinical Hematology_ Theory _ Procedures ( PDFDrive )

Principles o Blood Collection and
15 Macrocytic and Megaloblastic Anemias

CHAPTER Processing

KEY TERMS

folic acid de ciency macrocytosis vitam in B de ciency
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ineffective erythropoiesis megaloblastic anemia
intram edullary hem olysis pernicious anem ia

LEARNING OUTCOMES

Macrocytic anemias ■ Describe the clinical signs and symptoms of pernicious anemia.

■ Name, at least three, examples of conditions associated with non- Summarize the laboratory assays used to confirm cobalamin

megaloblastic macrocytosis. de ciency and state the results associated with pernicious anemia.

■ Describe how DNA synthesis differs in nonmegaloblastic macrocy- ■ Explain the usual management of and therapy for pernicious anemia.

tosis from megaloblastosis. Folic acid de ciency anemia

Megaloblastic anemias ■ List three etiologic causes of folate or folic acid de ciency.

■ De ne the term megaloblastic anemia. ■ Brie y describe the epidemiology of folate or folic acid de ciency.

Differentiate the pathophysiology and the appearance of red blood ■ Explain the physiology of folic acid de ciency.

cells on peripheral blood smears from patient’s with nonmegaloblas- ■ Describe the body’s requirements for folate and the physiologic role

tic anemia versus megaloblastic anemia. of folate.

■ Name the two common causes and other less common causes of Summarize the process of folic acid metabolism and explain how a

megaloblastic anemia. de ciency can result in megaloblastosis.

■ Explain the cellular maturation abnormalities in the bone marrow in ■ Describe the clinical signs and symptoms of folic acid de ciency.

megaloblastic anemias. ■ Name the laboratory assays used to con rm folic acid de ciency and

Assess an algorithm of clinical chemistry laboratory tests used to state the results associated with folic acid de ciency.

distinguish megaloblastic anemias. Case study

Pernicious anemia Analyze the patient history, clinical signs and symptoms, and labo-

■ Describe the body’s requirement for vitamin B and the physiologic ratory data for the stated case studies, answer the related critical
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role of vitamin B . thinking questions, and conclude the most likely diagnosis.
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■ List four etiologic causes of vitamin B de ciency and describe two
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distinguishing clinical or laboratory characteristics for each. NOTE:

■ Brie y describe the epidemiology of pernicious anemia. ■ indicates MLT and MLS core content

■ Explain the etiology and pathophysiology, including the immune indicates MLT (optional) and MLS advanced content
nature, of pernicious anemia.

V m m
MACROCY IC ANEMIAS
B x . . I m , -

Macrocytosis, m m mm m . M

m (MCV), m m m pernicious anemia

megaloblastic anemia x- m m m

m . F x m , MCV .

m m m mm N m m m k mm

, . m x m RBC

m . m DNA

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