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Folate Def (B9)
- Distroyed by 10 to 15 mins of cooking
- Celiac disease and tropical sprue affect uptake
- No neurological manifestations
-
Cobalamin Def (B12)
- B12 levels high in meat & dairy
- Western world, pernicious anemia, unless otherwise proven
- pernicious anemia: increased risk of gastric carcinoma
- Anemia, not neurological manifestation (treatable by vit B12)
- Demyelination of peripheral nerves, spinal cord
- Polycythemia
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Immunohemolytic Anemias
- Ab against RBC membrane components
- Diagnosis: Direct and Indirect Coombs Ag test
- Warm Ab: IgG, rarely igA: Active at 37 C
- Cold Ab: IgM bind RBC membranes only at 30 C
- Microangiopathic Hemolytic Anemia
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Malaria
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Plasmodium
- Falciparium
- Malariae, vivax, ovale
- Increased rate of RBC destruction
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Iron Deficiency Anemia
- Most common cause of anemia
- Iron: most common nutritional deficiency
- Iron content: Women = 2 gm & men= 6 gm
-
Anemia of Chronic Disease
- Pathogenesis: High levels of plasma hepcidin
- Most common anemia in hospitalized patients
-
Megaloblastic Anemia (Folate and B12 Def)
- Other myeloid lineage also affected
- Nuclear cytoplasmic asynchrony
- Hypochromic but MCHC normal
- Anemias of Diminished Erythropoeisis