Megaloblastic Anemia

Pathophysiology

100

Impaired ___ synthesis causing defective ____ maturation, charaterized by large ___

DNA

RBCs

RBCs (megaloblasts)

200

Easily destroyed due to fragile ___ ______

cell membranes

300

Megaloblastic anemia is resulted from what 2 types of deficiencies

Cobalamin (B12)

Folic Acid

400

B12 deficiency is caused because the lack of absorption where in the body

GI system

500

Folic acid is required for __________ and ________

erythropoiesis

Maturation

Signs and Symptoms

100

What would S/S look like in the GI system if a patient had cobalamin (B12) deficiency

Sore tongue

Anorexia

N/V

200

What would Neuromuscular S/S look like if a patient had cobalamin (B12) deficiency

Weakness

Paresthesia of feet and hands

Impaired thought process

300

What would S/S of folic acid deficiency look like in the GI system of a patient

Dyspepsia

Smooth beefy red tongue

Diagnostics/Labs

100

The Schilling Test helps to determine what kind of deficiency

Cobalamin (B12)

200

What blood test would be used to help diagnose cobalamin (b12) deficiency

Serum cobalamin (b12)

Folate

300

A biopsy of the _____ _____ can also help diagnose cobalamin (b12) deficiency

Gastric Mucosa

400

What labs can be used to help diagnose Folic Acid deficiency?

Serum cobalamin (b12)

Folate

500

Which test has a reference range of 190-950

Which test has a reference range of 3-16

Cobalamin B12 

Folate

Treatment

200

How can cobalamin (b12) deficiency be treated

 Parenteral or Intranasal admin of B12

300

If a patient is not treated for their Cobalamin (b12) deficiency, how long do they have to live?

1-3 years

400

How much folic acid per day for replacement is needed and how much is needed for someone who is an alcoholic

1mg/day

5mg/day

Nursing Interventions/Patient Education/Etiology

100

Cobalamin (b12) deficiency is most common in what type of ethnicities

Scandinavians and African Americans

200

What foods would you educate your patient on eating if they had folic acid deficiency

Green leafy veggies

Meat

300

What foods would you educate your patient on eating if they had Cobalamin (b12) deficiency

Red Meats (liver)

Eggs

Enriched grains

Milk

Dairy Fish

400

Name a few issues that could cause someone to end up having cobalamin (b12) deficiency

GI surgery

Chronic GI disorders

Excessive alcohol intake

Vegetarian

500

Name a few issues that could cause someone to end up having folic acid deficiency

Cirrhosis

Esophageal varices

Celiac

Crohns

Alcohol abuse

Anorexia

Medications: Methotrexate and Anti-seizures