Pernicious/Megaloplastic Anemia
/*! elementor – v3.12.1 – 02-04-2023 */
.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}
Vitamin B12 Deficiency (Pernicious/Megaloblastic Anemia)
/*! elementor – v3.12.1 – 02-04-2023 */
.elementor-accordion{text-align:left}.elementor-accordion .elementor-accordion-item{border:1px solid #d5d8dc}.elementor-accordion .elementor-accordion-item+.elementor-accordion-item{border-top:none}.elementor-accordion .elementor-tab-title{margin:0;padding:15px 20px;font-weight:700;line-height:1;cursor:pointer;outline:none}.elementor-accordion .elementor-tab-title .elementor-accordion-icon{display:inline-block;width:1.5em}.elementor-accordion .elementor-tab-title .elementor-accordion-icon svg{width:1em;height:1em}.elementor-accordion .elementor-tab-title .elementor-accordion-icon.elementor-accordion-icon-right{float:right;text-align:right}.elementor-accordion .elementor-tab-title .elementor-accordion-icon.elementor-accordion-icon-left{float:left;text-align:left}.elementor-accordion .elementor-tab-title .elementor-accordion-icon .elementor-accordion-icon-closed{display:block}.elementor-accordion .elementor-tab-title .elementor-accordion-icon .elementor-accordion-icon-opened,.elementor-accordion .elementor-tab-title.elementor-active .elementor-accordion-icon-closed{display:none}.elementor-accordion .elementor-tab-title.elementor-active .elementor-accordion-icon-opened{display:block}.elementor-accordion .elementor-tab-content{display:none;padding:15px 20px;border-top:1px solid #d5d8dc}@media (max-width:767px){.elementor-accordion .elementor-tab-title{padding:12px 15px}.elementor-accordion .elementor-tab-title .elementor-accordion-icon{width:1.2em}.elementor-accordion .elementor-tab-content{padding:7px 15px}}.e-con-inner>.elementor-widget-accordion,.e-con>.elementor-widget-accordion{width:var(–container-widget-width);–flex-grow:var(–container-widget-flex-grow)}
Patho
- Pernicious anemia: Intestines cannot absorb B12 due to lack of intrinsic factor.
- Megaloblastic anemia: there is a deficiency of vitamin B-12.
- Schilling test measures Vitamin B12 Absorption and differentiates between megaloplastic and pernicious anemia
- Looks for Vitamin B12 in the urine after client is given a dose of radioactive B12.
- If pernicious anemia that patient does not absorb B12 and it will not show on the urine. KNOW THIS!
- An elevated schilling test = client can absorb B12
- So no B12 in urine = pernicious anemia (B12 not absorbed)
- Test rarely done today
- Poor intake of Vitamin B12 (megaloplastic): vegetarian diets and low dairy intake.
- Poor absorption of B12: small bowel resection, chronic diarrhea, IBD, Diverticula, Tapework/overgrowth of intestinal bacteria.
- Increased dietary itake of Vitamin B12 (meat/poultry/shellfish, eggs, dairy)
- Pernicious anemia: needs vitamin B12 weekly, then monthly for the rest of their lives (cannot absorb B12, remember?)
- NCLEX show-ups on pernicious anemia signs and symptoms: Angular cheilitis (scaling lips/corner of mouth), smooth-bright red tongue, sensitivity to cold, dyspnea on exertion.
- Vitamin B12 nasal spray (cyanocobalamin aka Calomist)
- Increased dietary itake of Vitamin B12 (meat/poultry/shellfish, eggs, dairy)
- Pernicious anemia: needs vitamin B12 weekly, then monthly for the rest of their lives (cannot absorb B12, remember?)
- Vitamin B12 nasal spray (cyanocobalamin aka Calomist)
- Where to inject B12: Ventrogluteal and dorsogluteal muscle