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Macrocytosis & Macrocytic Anaemia

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Macrocytosis & Macrocytic Anaemia lecture given on tuesday of week 1
Matthew Coulson
Quiz by Matthew Coulson, updated more than 1 year ago
Matthew Coulson
Created by Matthew Coulson about 5 years ago
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Resource summary

Question 1

Question
[blank_start]Macrocytosis[blank_end] = An increase in larger than normal red blood cells [blank_start]Macrocytic Anaemia[blank_end] = A reduction in red blood cells, however the red blood cells have a larger than normal volume
Answer
  • Macrocytic Anaemia
  • Macrocytosis

Question 2

Question
Mean Corpuscular Volume (MCV) is measured using which units? [blank_start]Femtolitres[blank_end]
Answer
  • Femtolitres

Question 3

Question
The examples below showcase the difference between macrocytosis and macrocytic anaemia. Label them.
Image:
Picture95 (binary/octet-stream)
Answer
  • Macrocytic Anaemia
  • Macrocytosis

Question 4

Question
TYPICAL EXAM QUESTION: Normally sized red blood cells should be a similar size to [blank_start]the nucleus of a normal small lymphocyte[blank_end]
Answer
  • the nucleus of a normal small lymphocyte
  • a normally sized reticulocyte
  • the nucleus of a normal small neutrophil

Question 5

Question
At the point where a developing RBC leaves the bone marrow and loses its nucleus, it is called a [blank_start]reticulocyte[blank_end]
Answer
  • reticulocyte

Question 6

Question
As the erythropoietic pathway progresses, the overall cell size becomes [blank_start]smaller[blank_end] as the haemoglobin [blank_start]concentrates[blank_end]
Answer
  • concentrates
  • spreads out
  • smaller
  • larger

Question 7

Question
At the first step of erythropoiesis, the cell is called a
Answer
  • Pronormoblast
  • Basophilic Normoblast
  • Polychromatophilic Normoblast
  • Orthochromatic Normoblast

Question 8

Question
A red cell precursor (like a normoblast) which is abnormally large and has an immature nucleus is called a [blank_start]megaloblast[blank_end]
Answer
  • megaloblast

Question 9

Question
TYPICAL EXAM QUESTION: Which of the following aspects of erythropoiesis are defective in the development of a megaloblastic red blood cell?
Answer
  • DNA Synthesis
  • Nuclear Maturation
  • RNA Synthesis
  • Haemoglobin Synthesis

Question 10

Question
Which of the following are preserved in megaloblastic red blood cells?
Answer
  • DNA Synthesis
  • Nuclear Maturation
  • RNA Synthesis
  • Haemoglobin Synthesis

Question 11

Question
Macrocytic Anaemia is most commonly caused by deficiency of which Vitamins? (2 Answers)
Answer
  • Thiamine (B1)
  • Niacin (B3)
  • Pyridoxine (B6)
  • Folate (B9)
  • Cobalamin (B12)

Question 12

Question
Silencing of genes occurs by a donor molecule adding a [blank_start]methyl[blank_end] group to a specific section of a DNA strand.
Answer
  • methyl

Question 13

Question
The [blank_start]Folate[blank_end] Cycle is important for regulating the conversion of the [blank_start]U[blank_end] base of RNA to the [blank_start]T[blank_end] base of DNA. Disruption of this can cause nuclear maturation leading to macrocytic anaemia.
Answer
  • T
  • A
  • C
  • G
  • U
  • G
  • C
  • A
  • Folate
  • Methionine
  • Cobalamin

Question 14

Question
The [blank_start]Methionine[blank_end] Cycle (regulated by Vitamin [blank_start]B12[blank_end]) is important for the production of a donor molecule for DNA methylation, so that certain genes can be 'silenced'. Disruption of this cycle can cause defective nuclear maturation and thus macrocytic anaemia.
Answer
  • Methionine
  • Folate
  • Cobalamin
  • B12
  • B9

Question 15

Question
The Methionine Cycle regards the conversion of [blank_start]homocysteine[blank_end] to methionine via Vitamin B12 in order to produce a donor molecule for DNA strand methylation
Answer
  • homocysteine

Question 16

Question
B12 Absorption System: B12 enters stomach and is immediately bound by the [blank_start]R[blank_end]-binding protein
Answer
  • R

Question 17

Question
B12 Absorption System: Which protein is then released by stomach cells to bind to B12? [blank_start]Intrinsic Factor[blank_end]
Answer
  • Intrinsic Factor

Question 18

Question
B12 Absorption System: Which type of cells release intrinsic factor from the stomach? The gastric [blank_start]parietal[blank_end] cells
Answer
  • parietal

Question 19

Question
B12 Absorption System: B12 dissociates from R-binding protein and binds to Intrinsic Factor, before moving as this complex to the [blank_start]distal[blank_end] [blank_start]ileum[blank_end] where it dissociates from Intrinsic Factor and is absorbed via specific receptors.
Answer
  • distal
  • proximal
  • ileum
  • duodenum
  • jejunum

Question 20

Question
B12 Absorption System: The receptors which absorb Vitamin B12 in the distal ileum after it has dissociated from Intrinsic Factor are called [blank_start]Cubulin[blank_end] Receptors
Answer
  • Cubulin

Question 21

Question
A 67 year old man presents to you with chronic fatigue and nausea & vomiting. He has a past medical history of Vitiligo and Rheumatoid Arthritis. What is the most likely diagnosis for this man? [blank_start]Pernicious Anaemia[blank_end]
Answer
  • Pernicious Anaemia

Question 22

Question
Anaemia caused by the autoimmune destruction of the gastric parietal cells is called [blank_start]Pernicious anaemia[blank_end]
Answer
  • Pernicious anaemia

Question 23

Question
Pernicious Anaemia results in the deficiency of which protein needed for B12 absorption? [blank_start]Intrinsic Factor[blank_end]
Answer
  • Intrinsic Factor

Question 24

Question
Pernicious Anaemia should be treated with Vitamin B12 via which route of administration?
Answer
  • Oral
  • Subcutaneous
  • Intravenous
  • Intramuscular
  • Sublingual

Question 25

Question
Folate is typically absorbed in the ...
Answer
  • Duodenum
  • Jejunum
  • Ileum

Question 26

Question
Individuals abiding by a Vegan diet are more likely to become deficient in [blank_start]Vitamin B12[blank_end], due to the fact that it is commonly ascertained in our diets via animal meat.
Answer
  • Vitamin B12
  • Folate

Question 27

Question
Which of the following conditions may result in B12/Folate deficiency?
Answer
  • Crohn's Disease
  • Ulcerative Colitis
  • Coeliac Disease
  • Gastric Ulcers

Question 28

Question
Alcoholics are more likely to develop [blank_start]Folate[blank_end] deficiency
Answer
  • Folate
  • Vitamin B12

Question 29

Question
Which of the following drug types can cause folate deficiency?
Answer
  • Antipsychotics
  • Anticonvulsants
  • Antiarrhythmics
  • Antidepressants

Question 30

Question
Which three of the following symptoms are indicative of either a B12 or Folate deficiency?
Answer
  • Sore tongue
  • Weight loss
  • Diarrhoea
  • Headache
  • Blurred vision

Question 31

Question
Which deficiency anaemia can cause neurological problems such as dorsal column dysfunction and dementia?
Answer
  • Folate deficiency
  • B12 deficiency

Question 32

Question
When all cells are low in number (RBCs, WBCs and Platelets) this is known as [blank_start]pancytopenia[blank_end]
Answer
  • pancytopenia

Question 33

Question
Another way of diagnosing macrocytic anaemia is via the discover of hypersegmented [blank_start]neutrophils[blank_end] on the blood film
Answer
  • neutrophils

Question 34

Question
Neutrophils typically have [blank_start]3-5[blank_end] nuclear segments, if there are more than this then this is a potential sign of macrocytic anaemia
Answer
  • 3-5
  • 2-3
  • 4-7

Question 35

Question
Which two of the following autoantibodies are used in conjunction to diagnose B12-deficiency anaemia?
Answer
  • Anti-IF
  • Anti-GPC
  • Anti-RBP
  • Anti-CR

Question 36

Question
Folic acid tablets for Folate-deficiency anaemia are typically [blank_start]5mg[blank_end] per day oral tablets.
Answer
  • 5mg
  • 0.5mg
  • 15mg
  • 50mg

Question 37

Question
The recommendation for folic acid supplementation in pregnancy is [blank_start]0.4mg[blank_end] daily
Answer
  • 0.4mg
  • 4mg
  • 14mg
  • 40mg

Question 38

Question
[blank_start]Spurious Macrocytosis[blank_end] = Red Blood Cell Volume is normal yet the MCV is high [blank_start]Genuine Macrocytosis[blank_end] = Red Blood Cell Volume is abnormally large and MCV is high
Answer
  • Genuine Macrocytosis
  • Spurious Macrocytosis

Question 39

Question
Which three of the following can cause spurious macrocytosis?
Answer
  • Alcoholism
  • Liver disease
  • Hypothyroidism
  • Hyperthyroidism
  • Drug overdose
  • Kidney Disease

Question 40

Question
When red cells clump together causing the MCV machine to register them as 1 giant red cell, these clumps are known as [blank_start]cold agglutinins[blank_end]
Answer
  • cold agglutinins

Question 41

Question
Patients with pernicious anaemia can appear mildly [blank_start]jaundiced[blank_end] due to intramedullary haemolysis
Answer
  • jaundiced
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