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Medicine

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Hematology

Question
1 out of 16
 

Macrocytic anemia may be seen with all of the following conditions except: (LQ)



A Liver disease
B Copper deficiency

C Thiamine deficiency
D Orotic aciduria

Ans. B

Copper deficiency

Causes of macrocytic anaemia

1. Macrocytic megaloblastic anaemia

a. BM abnormal, all precursors of RHC, WBC & platelet are megaloblastic along with peripheral blood macrocytosis.

b. Responsive to Vit B12 / folate therapy

c. Causes includes

i. Vit B12 Deficiency

ii. Folate Deficiency

iii. Therapy with antifolate drug

d. DH reductase inhibitors – Methotrexate, trimethoprim, pyrimethamine, cotrimoxazole, pentamidine

e. Other – Anticonvulsant (Phenytoin, Primidone, Phenobarbitone, NO), OCP

4. Drugs that inhibit DNA synthesis

a. Purine antagonist – 6 mercaptopurine, azathioprine

b. Pyrimidine antagonist – 5FU, cytosine arabinoside

c. Others – Hydroxyurea, Zidovudine, acyclovir, Procarbazine

2. Macrocytic normoblastic anaemia

a. BM percussors are normoblastic, either reticulocyte or mature RBC show increase size (Macrocyte)

b. Unresponsive to Vit B12 / folate therapy

c. Causes i. Orotic aciduria ii. Liver disease

iii. Hypothyroidism iv. Thiamine deficiency

v. Alcoholism vi. Nitrous oxide inhalation

Extra Edge: Normal values of vitamin B12 is >250 pg/ml

Hematology Flashcard List

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