Diseases Of Blood And Blood Forming Organs Important Question And Answers

Diseases Of Blood And Blood Forming Organs Important Question And Answers

Question 1. Write short note on pernicious anemia.

Answer. Pernicious anemia is a type of a chronic progressive, megaloblastic anemia of adults and is caused by a deficiency of intrinsic factors in stomach.

Etiology

• Due to impaired absorption of vitamin B12: This occurs due to the atrophy of gastric mucosa which results in lack of secretion of intrinsic factor.
• As autoimmune reaction to gastric parietal cells or intrinsic factor.
• Strict vegetariAns suffr from vitamin B12 deficiency as it is present only in eggs, meat, and milk.
• Malabsorption of vitamin B12 due to inadequate gastric production or defective functioning of intrinsic factor.
• Various other causes which lead to the deficiency of vitamin B12 are gastrectomy, celiac disease, Crohn’s disease, alcoholism, prolong usage of drugs, i.e. proton pump inhibitors, colchicines.

Clinical Features

• Generalized weakness, palpitation, nausea, vomiting, anorexia, diarrhea and dyspnea.
• Patients have smooth, dry, and yellow skin.
• Neurological manifestation includes tingling sensation in hand and feet, paresthesia of extremities due to peripheral nerve degeneration.
• Glossitis, glossodynia (painful tongue) and glossopyrosis (itching and burning tongue).
• Tongue appears beefy red in color.
• Sometimes loss of papilla produces a bald appearance of tongue.
• Sometimes hyperpigmentation occurs in mucosa.
• Inflmmation and burning sensation surround entire oral mucosa.

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Read And Learn More: Oral Pathology Question And Answers

Histopathology

• Oral epithelial cells become enlarged and show hyperchromatic nuclei with prominent nucleoli along with serrated nuclear membrane.
• Epithelium becomes atrophic.
• There is presence of subepithelial chronic inflmmatory cell infitration.

Laboratory Findings

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• Macrocytosis is commonly seen.
• Red blood cell count is decreased, at times it is 10 lakh/cubic mm of blood.
• Mild to moderate thrombocytopenia is also seen.
• MCV, MCH, MCHC concentration is normal
• Howell jolly bodies and cabot rings are present.
• Neutrophils are hypersegmented.
• Buccal scrapings show nuclear abnormalities
• Schilling test show vitamin B12 deficiency.
• Serum lactate dehydrogenase is markedly increased while serum potassium, cholesterol and skeletal alkaline phosphatase are often decreased.
• Bone marrow is hypercellular and show trilineage differentiation.
• Erythroid precursors are large and oval. Nucleus is large and contains coarse motley chromatin clumps giving checkboard appearance.

Treatment

IM injection of vitamin B12 is given.