Answer:
Diet may be normal in vitamin B12 deficiency, but patients with folate deficiency may be alcoholics or have a diet consisting mainly of junk food and “tea and toast,” with no green vegetables.
Neurologic disease in vitamin B12 deficiency is subacute and involves combined systems; in folate deficiency it is absent or associated with alcohol.
Reference: Babior [...]
Archive for the 'Hematology' Category
Question: How do diet and neurologic disease differ in vitamin B12 and folate deficiencies?
Wednesday, December 5th, 2007Posted in Hematology | No Comments »
Question: What is chronic intravascular hemolysis?
Wednesday, December 5th, 2007Answer:
Chronic intravascular hemolysis is a disorder usually seen in paroxysmal nocturnal hemoglobinuria, a rare stem cell disorder, or in patients with malfunctioning cardiac valves. Examination of urine sediment stained for iron discloses iron-laden tubular cells (hemosiderosis).
Reference: Greer JP, et al (eds): Wintrobe’s Clinical Hematology, 11th ed. Philadelphia, Lippincott Williams & Wilkins, 2004
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QUESTION: What are the causes and consequences of IRON overload
Saturday, September 8th, 2007Answer:
Overload of iron from chronic administration to non-iron deficient persons, chronic transfusion therapy, hemochromatosis, amd in patients with thalassemia major and certain refractory anemias such as sideroblastic anemia.
Iron overload has many effects
Cardiomyopathy, arrhythmias
Hepatic dysfunction and cirrhosis
Hepatoma
Endocrine dysfunction (hypothyroidism, hypogonadotrophic hypogonadism, hyperpigmentation, diabetes mellitus)
Arthropathy (chondrocalcinosis, synovial fluid containing calcium pyrophosphate or hydroxyapatite crystals)
Osteopenia and subcortical [...]
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Question: What are common causes of IRON deficiency?
Thursday, September 6th, 2007Answer:
Iron deficiency results from dietary causes, malabsorption (sprue, postgastrectomy patients), chronic blood loss (gastrointestinal, menstrual loss and pregnancy), and chronic intravascular hemolysis. The last mentioned is usually seen in the rare stem cells disorder paroxysmal nocturnal hemoglobinuria (PNH) or in patients with malfunctioning cardiac valves. Examination of a urine sediment stained for iron discloses [...]
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QUESTION: In the treatment of Iron Deficiency Anemia, how much iron should be administered, in what form, and for how long?
Thursday, September 6th, 2007Answer:
Iron is best given as ferrous sulfate in a formulation that does not include enteric coating. Typically, patients take 325mg PO TID until the anemia corrects and for several months thereafter. This provides 60mg of elemental iron per tablet, or 180mg per day. Of this, 18-36mg can be absorbed and utilized by an otherwise unimpaired [...]
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What are the two most helpful laboratory investigations in the initial evaluation of anemia?
Thursday, August 16th, 2007The reticulocyte count and review of the peripheral blood film are the basis of a methodical approach to anemia. The peripheral blood film will demonstrate whether or not important abnormalities of red blood cell (RBC) shape, size, or hemoglobinization exist. In addition, an impression of the white blood cell (WBC) count and platelet count can [...]
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