The Macrocytic Anemias and the Megaloblastic Process
The Red Cell Precursors in Megaloblastic Anemia
Ineffective Erythropoiesis in Megaloblastic Anemia
Vitamin B12 and Folic Acid: Their Role in DNA Synthesis
Nutritional Requirements, Transport, and Metabolism of Vitamin B12 and Folic Acid
Incorporating Vitamin B12 Into the Bone Marrow
Clinical Features of Patients With Megaloblas-tic Anemia
Hematological Features of Megaloblastic Anemias
Pernicious Anemia as a Subset of Megaloblastic Anemias
Vitamin B12 and Folic Acid Deficiency
Laboratory Diagnosis of Megaloblastic Anemias
Treatment and Response of Individuals With Megaloblastic Anemia
Macrocytic Anemias That Are Not Megaloblastic
After completing this chapter, the student will be able to:
1. Define megaloblastic anemia as a macrocytic anemia.
2. Compare and contrast the morphological characteristics of megaloblasts and normoblasts in the bone marrow.
3. Differentiate red cell and white cell changes in the peripheral smear that are seen in the mega-loblastic anemias.
4. Describe ineffective hematopoiesis as it relates to the megaloblastic process.
5. Describe the pathway of vitamin B12 and folic acid from ingestion through incorporation into the red cell.
6. Describe the clinical symptoms of a patient with megaloblastic anemia.
7. List the causes of vitamin B12 and folic acid deficiency.
8. Define pernicious anemia and its clinical and laboratory findings.
9. Describe the Schilling test and its use in diagnosing megaloblastic anemia.
10. Describe the treatments for the megaloblastic anemias.
11. Differentiate the anemias that are macrocytic but are not megaloblastic.
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