Vitamin B12 and folate deficiencies can cause megaloblastic anemia. The document discusses the roles of vitamin B12 and folate in DNA synthesis and cell maturation. It outlines the pathways of vitamin B12 and folate metabolism and consequences of deficiencies. Diagnosis involves blood tests of vitamin B12, folate, methylmalonic acid, and homocysteine levels as well as blood smears examining red blood cell size and shape. Treatment involves vitamin B12 and folate supplementation orally or via injection.
1) The document discusses iron status tests including serum iron, total iron binding capacity, and ferritin.
2) It describes the principles, reagents, and normal ranges for serum iron and total iron binding capacity tests performed using a manual method.
3) Details are provided on the preparation of deionized water, hydrochloric acid, iron standards, and chromogens used in the tests.
Chronic Myeloid Leukemia (CML) adalah leukemia kronis yang disebabkan oleh proliferasi sel myeloid yang tidak terkontrol akibat abnormalitas genetik. CML ditandai dengan leukositosis, dominasi sel neutrophil, dan kromosom Philadelphia. Terapi lini pertama untuk fase kronis adalah obat golongan tyrosine kinase inhibitor seperti imatinib, sedangkan untuk fase akselerasi dan krisis blastik direkomendasikan transplantasi sel punca darah.
The document discusses flow cytometry and its clinical application in monitoring CD4 T lymphocyte counts. Flow cytometry works by passing fluorescent-labeled cells in a fluid stream through a laser which causes fluorescence. Detectors then measure the cells' light scattering and fluorescence properties to characterize the cells and identify subsets. The document provides details on using the BD FACSCalibur flow cytometer to measure CD4 counts via two-color staining and gating on T lymphocyte populations. Normal CD4 values in adults and children are listed.
Parameter penentu resistensi insulin dapat ditentukan menggunakan berbagai metode seperti euglycemic hyperinsulinemic clamp, analisis minimal model FSIGT, tes toleransi glukosa oral, dan HOMA. Metode yang paling akurat adalah euglycemic hyperinsulinemic clamp namun metode ini rumit dan mahal."
1) The document discusses iron status tests including serum iron, total iron binding capacity, and ferritin.
2) It describes the principles, reagents, and normal ranges for serum iron and total iron binding capacity tests performed using a manual method.
3) Details are provided on the preparation of deionized water, hydrochloric acid, iron standards, and chromogens used in the tests.
Chronic Myeloid Leukemia (CML) adalah leukemia kronis yang disebabkan oleh proliferasi sel myeloid yang tidak terkontrol akibat abnormalitas genetik. CML ditandai dengan leukositosis, dominasi sel neutrophil, dan kromosom Philadelphia. Terapi lini pertama untuk fase kronis adalah obat golongan tyrosine kinase inhibitor seperti imatinib, sedangkan untuk fase akselerasi dan krisis blastik direkomendasikan transplantasi sel punca darah.
The document discusses flow cytometry and its clinical application in monitoring CD4 T lymphocyte counts. Flow cytometry works by passing fluorescent-labeled cells in a fluid stream through a laser which causes fluorescence. Detectors then measure the cells' light scattering and fluorescence properties to characterize the cells and identify subsets. The document provides details on using the BD FACSCalibur flow cytometer to measure CD4 counts via two-color staining and gating on T lymphocyte populations. Normal CD4 values in adults and children are listed.
Parameter penentu resistensi insulin dapat ditentukan menggunakan berbagai metode seperti euglycemic hyperinsulinemic clamp, analisis minimal model FSIGT, tes toleransi glukosa oral, dan HOMA. Metode yang paling akurat adalah euglycemic hyperinsulinemic clamp namun metode ini rumit dan mahal."
Dokumen tersebut membahas sindrom mielodisplastik yang merupakan kelompok penyakit neoplastik pada sel induk hemopoietik yang ditandai oleh kegagalan sumsum tulang dan kelainan sel darah. Dibahas pula patogenesis, diagnosis, klasifikasi, dan prognosis sindrom mielodisplastik menurut WHO dan terapi yang diberikan.
1. Dokumen tersebut membahas tentang pengantar dasar-dasar imunoasai (serologi) yang mencakup konsep dasar reaksi antara antigen dan antibodi, komponen penting antibodi, dan berbagai jenis uji serologi seperti uji presipitasi, aglutinasi, dan imunofluoresensi.
2. Beberapa teknik uji serologi yang dijelaskan antara lain uji ELISA, RIA, dan uji aliran samping menggunakan label seperti enzim dan
This document discusses thyroid hormone tests (T3, T4, TSH, fT4) and provides information about:
- The hormones T3 and T4, their functions, and how they are regulated
- Test methods for measuring T3, T4, TSH, and fT4 levels including RIA, IRMA, EIA, ELISA, and ECLIA
- Reference ranges and clinical significance of results for each hormone test
- Factors that can influence thyroid hormone levels such as medications, binding proteins, and thyroid disorders
Glomerulonefritis Acute Post Streptococcus patofisiologi dan terapi
Please contact me if you necessity to this presentation in gilangrizki.alfarizi@gmail.com
Pemeriksaan anti sterptolisyn (asto) xi tlmmateripptgc
Ringkasan singkat dokumen tentang pemeriksaan antistreptolisin (ASTO) untuk mendeteksi infeksi bakteri Streptococcus yang menyebabkan demam rematik:
1. Pemeriksaan ASTO mengukur kadar antibodi terhadap streptolisin O yang dihasilkan bakteri Streptococcus
2. Cara kerjanya dengan melihat terjadinya aglutinasi antara partikel lateks yang dilapisi streptolisin O dengan serum pasien
3. Hasil positif menandakan adanya infeksi
Metode CMIA adalah modifikasi dari ELISA yang menggunakan konjugat akridinium dan mikropartikel paramagnetik. CMIA memiliki sensitivitas tinggi untuk mendeteksi berbagai analit seperti antigen virus, metabolit, dan penanda tumor. CMIA cocok untuk pemeriksaan skrining massal meskipun membutuhkan peralatan khusus dan biaya yang lebih tinggi.
[Ringkasan]
1. Pasien berumur 18 bulan datang dengan keluhan demam dan bintik merah yang semakin banyak di kaki disertai lebam.
2. Pemeriksaan fisik menunjukkan status gizi kurang, petekia dan purpura di kulit, serta trombositopenia pada pemeriksaan darah.
3. Diagnosis kerja Idiopathic Thrombocytopenic Purpura berdasarkan gejala klinis dan hasil laboratorium.
1. Artikel menjelaskan enam ciri utama (hallmarks) sel kanker yang mengatur transformasi sel normal menjadi sel kanker, yaitu kemandirian sinyal pertumbuhan, ketidakpekaan terhadap sinyal anti-pertumbuhan, menghindari apoptosis, potensi replikatif tak terbatas, angiogenesis yang berkelanjutan, serta invasi jaringan dan metastasis.
2. Pada tahun 2011, empat ciri baru ditambahkan yaitu deregulated metabolism, ketidakstabilan DNA gen
Anemia hemolitik adalah kondisi dimana jumlah sel darah merah menurun akibat peningkatan destruksi sel darah merah sebelum akhir umur normalnya. Hal ini dapat disebabkan oleh faktor intrinsik seperti kelainan pada sel darah merah itu sendiri atau faktor ekstrinsik seperti sistem kekebalan tubuh yang salah mengenali sel darah merah. Rawatannya bergantung pada penyebabnya, misalnya transfusi darah atau obat unt
Dokumen tersebut membahas pentingnya mutu dalam layanan laboratorium klinik. Mutu hasil pemeriksaan dan layanan yang memenuhi standar dapat meningkatkan kepercayaan pasien dan dokter, serta mendukung kelancaran bisnis laboratorium. Dokumen tersebut juga menjelaskan berbagai ukuran mutu seperti akurasi, presisi, sensitivitas, dan spesifisitas; serta penggunaan kontrol kualitas dan aturan Westgard untuk memantau kualitas
Megaloblastic Anaemia - Vit B12 deficiencyShahin Hameed
This document discusses megaloblastic anemia caused by vitamin B12 deficiency. It covers the normal metabolism and absorption of vitamin B12, the causes of deficiency including pernicious anemia, clinical features such as macrocytic anemia and neurological changes, diagnostic tests, and management with parenteral B12 injections. Deficiency results in defective DNA synthesis and affects all proliferating cells.
Dokumen tersebut membahas sindrom mielodisplastik yang merupakan kelompok penyakit neoplastik pada sel induk hemopoietik yang ditandai oleh kegagalan sumsum tulang dan kelainan sel darah. Dibahas pula patogenesis, diagnosis, klasifikasi, dan prognosis sindrom mielodisplastik menurut WHO dan terapi yang diberikan.
1. Dokumen tersebut membahas tentang pengantar dasar-dasar imunoasai (serologi) yang mencakup konsep dasar reaksi antara antigen dan antibodi, komponen penting antibodi, dan berbagai jenis uji serologi seperti uji presipitasi, aglutinasi, dan imunofluoresensi.
2. Beberapa teknik uji serologi yang dijelaskan antara lain uji ELISA, RIA, dan uji aliran samping menggunakan label seperti enzim dan
This document discusses thyroid hormone tests (T3, T4, TSH, fT4) and provides information about:
- The hormones T3 and T4, their functions, and how they are regulated
- Test methods for measuring T3, T4, TSH, and fT4 levels including RIA, IRMA, EIA, ELISA, and ECLIA
- Reference ranges and clinical significance of results for each hormone test
- Factors that can influence thyroid hormone levels such as medications, binding proteins, and thyroid disorders
Glomerulonefritis Acute Post Streptococcus patofisiologi dan terapi
Please contact me if you necessity to this presentation in gilangrizki.alfarizi@gmail.com
Pemeriksaan anti sterptolisyn (asto) xi tlmmateripptgc
Ringkasan singkat dokumen tentang pemeriksaan antistreptolisin (ASTO) untuk mendeteksi infeksi bakteri Streptococcus yang menyebabkan demam rematik:
1. Pemeriksaan ASTO mengukur kadar antibodi terhadap streptolisin O yang dihasilkan bakteri Streptococcus
2. Cara kerjanya dengan melihat terjadinya aglutinasi antara partikel lateks yang dilapisi streptolisin O dengan serum pasien
3. Hasil positif menandakan adanya infeksi
Metode CMIA adalah modifikasi dari ELISA yang menggunakan konjugat akridinium dan mikropartikel paramagnetik. CMIA memiliki sensitivitas tinggi untuk mendeteksi berbagai analit seperti antigen virus, metabolit, dan penanda tumor. CMIA cocok untuk pemeriksaan skrining massal meskipun membutuhkan peralatan khusus dan biaya yang lebih tinggi.
[Ringkasan]
1. Pasien berumur 18 bulan datang dengan keluhan demam dan bintik merah yang semakin banyak di kaki disertai lebam.
2. Pemeriksaan fisik menunjukkan status gizi kurang, petekia dan purpura di kulit, serta trombositopenia pada pemeriksaan darah.
3. Diagnosis kerja Idiopathic Thrombocytopenic Purpura berdasarkan gejala klinis dan hasil laboratorium.
1. Artikel menjelaskan enam ciri utama (hallmarks) sel kanker yang mengatur transformasi sel normal menjadi sel kanker, yaitu kemandirian sinyal pertumbuhan, ketidakpekaan terhadap sinyal anti-pertumbuhan, menghindari apoptosis, potensi replikatif tak terbatas, angiogenesis yang berkelanjutan, serta invasi jaringan dan metastasis.
2. Pada tahun 2011, empat ciri baru ditambahkan yaitu deregulated metabolism, ketidakstabilan DNA gen
Anemia hemolitik adalah kondisi dimana jumlah sel darah merah menurun akibat peningkatan destruksi sel darah merah sebelum akhir umur normalnya. Hal ini dapat disebabkan oleh faktor intrinsik seperti kelainan pada sel darah merah itu sendiri atau faktor ekstrinsik seperti sistem kekebalan tubuh yang salah mengenali sel darah merah. Rawatannya bergantung pada penyebabnya, misalnya transfusi darah atau obat unt
Dokumen tersebut membahas pentingnya mutu dalam layanan laboratorium klinik. Mutu hasil pemeriksaan dan layanan yang memenuhi standar dapat meningkatkan kepercayaan pasien dan dokter, serta mendukung kelancaran bisnis laboratorium. Dokumen tersebut juga menjelaskan berbagai ukuran mutu seperti akurasi, presisi, sensitivitas, dan spesifisitas; serta penggunaan kontrol kualitas dan aturan Westgard untuk memantau kualitas
Megaloblastic Anaemia - Vit B12 deficiencyShahin Hameed
This document discusses megaloblastic anemia caused by vitamin B12 deficiency. It covers the normal metabolism and absorption of vitamin B12, the causes of deficiency including pernicious anemia, clinical features such as macrocytic anemia and neurological changes, diagnostic tests, and management with parenteral B12 injections. Deficiency results in defective DNA synthesis and affects all proliferating cells.
El documento habla sobre la anemia. Explica que la anemia es una disminución de la masa eritrocitaria y la concentración de hemoglobina en la sangre. Define los criterios de la OMS para diagnosticar la anemia. También describe los síntomas, signos y manifestaciones clínicas de la anemia, así como los parámetros de laboratorio que indican el tipo de anemia.
This study guide outlines the curriculum for assessing growth and development in children, adolescents, fetuses, and the elderly. The aims are to evaluate physical growth, diagnose and manage common nutritional disorders, investigate failure to thrive, identify congenital anomalies, and assess development. Learning outcomes include assessing growth, diagnosing nutritional problems, evaluating fetal growth, identifying developmental disorders, and managing common health issues in the elderly. The curriculum covers topics like normal growth patterns, nutritional impacts, fetal assessment, developmental domains, disorders, aging changes, and elderly health problems.
Dokumen tersebut membahas tentang validasi metode analisis, termasuk pengertian, tujuan, dan parameter-parameter validasi seperti akurasi, presisi, selektivitas, linearitas, batas deteksi dan kuantitasi, ketangguhan metode, dan kekuatan metode. Validasi metode analisis bertujuan untuk menunjukkan bahwa metode yang digunakan sesuai dengan tujuannya dan selalu memberikan hasil yang dapat dipercaya.
Modul ini membahas tentang pemeriksaan diagnostik sederhana yang dapat dilakukan untuk menganalisis sampel urine pasien, meliputi pemeriksaan organoleptis (warna, bau, buih), berat jenis, dan pH urine. Tujuannya adalah untuk mengetahui kondisi pasien berdasarkan hasil pemeriksaan tersebut."
This document discusses quality assurance in hematology laboratories. It defines key terms like accuracy, precision, and components of quality assurance like pre-analytical, analytical, and post-analytical stages. It describes the importance of proper specimen collection and handling in the pre-analytical stage. The analytical stage involves internal and external quality control. Specific controls for hematology analyzers like Latron beads and 6C & retics controls are discussed. The importance of result verification, critical value notification, and collaboration in the post-analytical stage is highlighted. Calibration, proficiency testing, and the role of risk assessment in ensuring patient safety are also summarized.
This document categorizes and describes different types of leukemia, including acute myeloid leukemia (AML) which is divided into subtypes M1 through M7 based on myeloblast maturity, acute lymphoblastic leukemia (ALL) which is separated into L1 through L3, chronic myeloid leukemia (CML), and chronic lymphocytic leukemia (CLL). It provides an overview of the main subtypes for each category of leukemia.
This document provides information on the definition, pathology, symptoms, signs, classification, and laboratory findings of anemia. It defines anemia as a reduction in hemoglobin concentration and oxygen carrying capacity in the blood. Anemias are classified based on whether red blood cell production or destruction is impaired. Common causes of microcytic anemia include iron deficiency and thalassemia. Thalassemia syndromes range from mild trait to severe thalassemia major depending on the number of functional globin genes. Laboratory findings helpful for diagnosing thalassemia include low MCV, MCH, and elevated HbA2.
Dokumen tersebut membahas tentang urinalisis atau analisis urine untuk tujuan diagnosis penyakit. Urinalisis meliputi pemeriksaan fisik, kimiawi, dan mikroskopik urine untuk mendeteksi berbagai kondisi kesehatan seperti infeksi saluran kemih, diabetes, dan kehamilan. Pemeriksaan urine merupakan uji penyaring yang bermanfaat untuk skrining awal berbagai penyakit.
The Schilling test is used to evaluate vitamin B12 absorption in patients with vitamin B12 deficiency. It has multiple stages where radiolabeled vitamin B12 is given orally and/or intravenously along with intrinsic factor. Urine is collected to measure absorption. Abnormal absorption could indicate pernicious anemia from lack of intrinsic factor or other causes of malabsorption. The test helps differentiate these causes of vitamin B12 deficiency.
Penyiasatan Diagnostik - Urinalisis, Hematology and RefloluxMuhammad Nasrullah
Dokumen tersebut membahas tentang urinalisis, yaitu analisis kimia, fisik, dan mikroskopik terhadap sampel air kencing untuk mendeteksi zat-zat normal dan abnormal serta mengetahui kondisi kesehatan saluran kemih dan organ dalam tubuh. Urinalisis digunakan untuk skrining rutin dan deteksi infeksi, diabetes, atau gangguan ginjal dan hati.
Megaloblastic anemia is caused by a deficiency of vitamin B12 or folate, which inhibits DNA synthesis during red blood cell formation. This leads to large, abnormally-developed red blood cells. Symptoms include anemia, neurological issues, and gastrointestinal problems. Diagnosis involves examination of blood smears to find megaloblasts, along with low vitamin B12 or folate levels. Treatment consists of vitamin B12 injections and oral folic acid supplementation. Pernicious anemia, a specific type, results from gastric atrophy and lack of intrinsic factor, requiring lifelong B12 injections.
Vitamin B12 deficiency can result in megaloblastic anemia characterized by large, immature red blood cells. It is most commonly caused by pernicious anemia where autoimmune destruction of gastric parietal cells leads to lack of intrinsic factor needed for vitamin B12 absorption. Clinical features include anemia, jaundice, and neurological problems. Diagnosis is based on morphological changes in blood and bone marrow showing megaloblasts, low vitamin B12 levels, and a positive Schilling test demonstrating impaired absorption. Treatment involves lifelong vitamin B12 injections or high dose oral supplementation.
Irion defitient and megaloblastic anemiasJasmine John
This document summarizes iron deficiency anemia and megaloblastic anemia. It discusses the causes, symptoms, laboratory findings, treatment, and prognosis of these conditions. Iron deficiency is the most common cause of anemia worldwide and results from inadequate iron intake or absorption. Megaloblastic anemia is caused by vitamin B12 or folate deficiencies and results in abnormal DNA synthesis and large, immature red blood cells. Treatment involves oral or intravenous iron supplementation for iron deficiency and vitamin B12/folate supplementation for megaloblastic anemia.
Folate and cobalamin are essential vitamins that play important roles in metabolism. Folate must be reduced to tetrahydrofolate to be functional, and a single enzyme catalyzes both steps of this reduction. Cobalamin is required for two key metabolic reactions involving methyltetrahydrofolate-homocysteine methyltransferase and methylmalonyl CoA mutase. Cobalamin deficiency can cause a "folate trap" by impairing methionine synthase and blocking folate metabolism. Tests for folate and cobalamin deficiencies include serum and RBC levels as well as metabolites like methylmalonic acid and homocysteine. The Schilling test evaluates cobalamin absorption by measuring ex
B12 metabolism..................................... and role of various proteins in b12 metabolism..... necessity of supplementation..........................................
This document discusses anemias caused by diminished red blood cell production. It covers various inherited and acquired causes, including nutritional deficiencies, bone marrow failure disorders, infiltrative bone marrow disorders, and decreased erythropoietin production. It focuses in depth on megaloblastic anemias caused by vitamin B12 and folate deficiencies, providing details on the mechanisms, morphology, and clinical features of pernicious anemia specifically.
This document provides information about megaloblastic anemia in children through a seminar presentation. It begins with an overview of hematology and the components of blood. It then discusses the causes of megaloblastic anemia as deficiencies in vitamins B12 and folic acid. The pathophysiology is described as impaired cell division leading to enlarged red blood cells called megaloblasts. Clinical manifestations include weakness, pale skin, and neurological issues. Diagnostic tests include blood counts and smears to examine red blood cells. Management involves vitamin B12 or folic acid supplementation through oral or injectable routes. Nursing care focuses on risks of ineffective tissue perfusion and activity intolerance due to anemia.
1. The document discusses various types of anemia including iron-deficiency anemia, vitamin B12 deficiency, and folate deficiency. It describes the stages of erythropoiesis, types of hemoglobin, definitions, classifications, etiologies, clinical features, laboratory findings, and treatment approaches for different anemias.
2. Iron-deficiency anemia is one of the most common and results from inadequate dietary iron intake or absorption. It presents with pallor and can cause developmental delays if untreated. Treatment involves oral iron supplementation.
3. Vitamin B12 and folate deficiencies can cause macrocytic anemia and neurological symptoms. Causes include dietary inadequacy or malab
The document discusses the components and functions of blood. It describes that blood is composed of plasma and formed elements such as red blood cells, white blood cells, and platelets. Red blood cells contain hemoglobin and are involved in oxygen transport. White blood cells help fight infection through phagocytosis or immune responses. Platelets assist in clotting to stop bleeding from damaged blood vessels. The lifecycles and production of the different blood components are also summarized.
Lab investigations of megaloblastic anaemiaAarthiKB
This document discusses laboratory investigations of megaloblastic anemia. Megaloblastic anemia results from vitamin B12 or folic acid deficiency, which impairs DNA synthesis. Diagnosis is based on blood tests showing macrocytic anemia and hypersegmented neutrophils, as well as bone marrow examination revealing megaloblasts with nuclear-cytoplasmic dissociation. Treatment involves vitamin B12 and folic acid supplementation, with hematological parameters improving within weeks as erythropoiesis becomes effective again.
This document discusses megaloblastic anemia, its causes, symptoms, and diagnostic tests. It begins by defining megaloblastic anemia as a group of disorders caused by deficiencies in vitamin B12 or folic acid. These deficiencies result in impaired DNA synthesis and defective cell maturation. Key symptoms include anemia, diarrhea/constipation, and glossitis. Diagnostic tests involve measuring serum levels of B12, folate, and homocysteine. Pernicious anemia, a type of megaloblastic anemia, is also discussed and is characterized by autoimmune destruction of gastric parietal cells and the absence of intrinsic factor.
Megaloblastic anemias are caused by deficiencies in vitamin B12 or folate which are needed for DNA synthesis. These deficiencies lead to large, immature red blood cells (megaloblasts) in the bone marrow. Symptoms include anemia, fatigue, weakness, and glossitis. The diagnosis involves blood tests to measure B12, folate, methylmalonate and homocysteine levels as well as examination of bone marrow cells which will show megaloblastic changes and chromosomal abnormalities. Treatment involves replacement of the deficient vitamin with either B12 or folate supplements.
Anemia is characterized by low levels of hemoglobin or red blood cells. It can be caused by inadequate red blood cell production, increased destruction, or blood loss. Anemia is classified based on red blood cell morphology, etiology, or pathophysiology. Common types include iron deficiency anemia, megaloblastic anemia caused by vitamin B12 or folate deficiencies, and hemolytic anemias where red blood cells are destroyed faster than they can be replaced. Symptoms vary depending on severity but can include fatigue, paleness, and shortness of breath.
Megaloblastic anemias are caused by an impairment of DNA synthesis leading to large, abnormally shaped red blood cells and their precursors. Pernicious anemia is a specific megaloblastic anemia caused by an autoimmune destruction of gastric parietal cells, resulting in impaired absorption of vitamin B12 and deficient DNA synthesis. It is characterized by megaloblastic changes in the bone marrow and gastrointestinal tract, and the presence of autoantibodies against intrinsic factor and gastric proton pumps. Left untreated, the impaired hematopoiesis leads to pancytopenia and anemia.
Information about megaloblastic anemia and it's etiology and its classification.
Vitmain b12 deficiencies
Folic acid deficiencies
Signs and symptoms of megaloblastic anemia
Neural tube defects
Vitamin B12, also known as cobalamin, is an essential water-soluble vitamin that plays critical roles in DNA synthesis, fatty acid and amino acid metabolism, and nerve cell function. It is naturally found in animal products and produced by bacteria. Deficiency can result in megaloblastic anemia and neurological problems. While generally safe, high doses may cause side effects like diarrhea or allergic reactions. Vitamin B12 has various applications in treating conditions like immune dysfunction, allergies, and cyanide poisoning.
This document summarizes megaloblastic anemias caused by vitamin B12 deficiency. It describes the normal metabolism and absorption of vitamin B12, the causes of deficiency including pernicious anemia and diseases interfering with absorption. The morphological features in blood and bone marrow include macrocytic anemia and megaloblasts. Diagnosis involves low B12 levels, elevated methylmalonic acid and homocysteine, and an abnormal Schilling test. Treatment is lifelong intramuscular B12 injections.
Vitamin B12 deficiency is common in India, especially among vegetarians and the elderly. It causes hematological, neurological, gastrointestinal and vascular issues. The document discusses causes of B12 deficiency including pernicious anemia and intestinal malabsorption. Clinical manifestations and investigations for diagnosis are explained. Treatment involves lifelong B12 supplementation through injections or high dose oral supplements. Preventive measures for high risk groups like vegetarians and post-gastric surgery patients are also covered.
The aim of this work is to illustrate a difficult diagnostic in vitamin B12 deficiency because of using of multivitamin preparations to a patient with unknown etiology of anemia. History Patient: a 70 year old engineer, following 8 years vegetable – dietary, was admitted to the county hospital, in neurology department, with diagnostic of poli-radiculonevrites, received in ward the treatment with milgama (containing 250 micro-gram multivitamin). After a lipotimia status the patient was transferred to cardiology department. Laboratory examinations showed in peripheral blood: Hb = 6 3 g/dl; Ht = 18.8%; RBC= 290.000/mm³; PLT. = 214000/mm³; WBC = 5300/³mm; Ret. = 3, 7%; Erythrocytes indices = normal values; ESR = 38 mm/h, moderate increase and serum iron decreased, 36 microgram/dl value. On blood smear in optic microscopy was registered: Band = 5% (with nucleus in ring!!!), differential count being normally with aspect flags on Coulter HMX Analyzer with 22 parameters: neutrophilia, lymphopenia, anemia. To microscopic examination of slide from bone morrow, have occurred the hyperplasic series of erythrocytes ~ 45%, deficiency of erythropoiesis, poly-cromathopil and acidophil erythroblasts with megaloblastic character, large metamielocytes and giant band forms. Macrocytes and ovalocytes where also presented. Biopsy results from gastric mucosa showed lesions of chronic gastritis, non-atrophic epithelium. Conclusions: Megaloblastosis appears in some time with vitamin B12 deficiently in bone morrow but no in peripheral blood because of administration of multivitamin drugs, deleting haematological shape of megaloblastic anemia.
Teks ini membahas tentang pengujian antibodi antinuklir (ANA) pada penyakit sistemik lupus eritematosus (SLE). Metode pengujian ANA meliputi pemeriksaan imunofluoresensi pada sel Hep-2, tes ELISA, dan tes strip Euroline. Pemeriksaan ini digunakan untuk mendiagnosis dan memantau SLE karena keberadaan ANA dapat menunjukkan aktivitas penyakit.
The document discusses viral load testing using NASBA (Nucleic Acid Sequence-Based Amplification) technology. It describes the NASBA process which uses 3 enzymes to amplify viral RNA or DNA in one temperature. The document provides examples of using NASBA to test viral load in HIV samples and discusses the benefits of NASBA including its high throughput, minimal hands-on time, and ability to detect down to 10-10^7 copies/ml.
This document summarizes methods for quantitatively determining serum immunoglobulin A (IgA) concentration, including radial immunodiffusion (RID), nephelometry, and enzyme-linked immunosorbent assay (ELISA). RID involves measuring the diameter of precipitation rings formed between serum IgA and antibody-containing agar. Nephelometry measures light scatter from immune complexes formed between serum IgA and anti-IgA antiserum. ELISA uses a capture antibody to bind serum IgA and a labeled secondary antibody for detection. ELISA provides the best sensitivity while nephelometry is most commonly used in clinical labs due to its rapid automation capabilities. Normal IgA levels, deficiencies, and causes of high values are also
Teks ini membahas tentang elektroforesis kapiler menggunakan alat Minicap untuk memisahkan molekul seperti protein, lipoprotein, isoenzim, dan hemoglobin. Metode ini bekerja dengan memisahkan molekul berdasarkan kecepatan elektroforesisnya dalam tabung kapiler dengan diameter 100 μm yang dipengaruhi pH elektrolit dan aliran elektroosmosis. Teks ini juga menjelaskan prosedur dan komponen elektroforesis protein, hemoglobin, dan immunotyping
This document discusses thyroid hormone tests (T3, T4, TSH, fT4) and their principles, procedures, and clinical significance. It describes the hormones T3 and T4, how they are regulated by the hypothalamus-pituitary-thyroid axis, and common thyroid disorders like hypothyroidism and hyperthyroidism. It provides details on specific assays for the hormones, including radioimmunoassay, immunoradiometric assay, enzyme immunoassay, and electrochemiluminescent assay. Reference ranges and clinical implications of test results are also covered.
1. Western Blot dan RIBA merupakan tes konfirmasi untuk infeksi HIV yang mendeteksi antibodi terhadap protein inti, polimerase, dan envelope virus HIV.
2. Terdapat perbedaan antara Western Blot dan RIBA dalam hal protein yang digunakan sebagai antigen.
3. Hasil tes dapat negatif palsu, indeterminate, atau positif tergantung pola protein HIV yang terdeteksi.
Dokumen tersebut membahas tentang pemeriksaan kadar antigen CA 125 dengan metode ELISA untuk skrining, diagnosis, pemantauan terapi, dan prognosis kanker ovarium. Metode ELISA digunakan karena ekonomis dan sensitivitas yang tinggi. Kadar CA 125 yang meningkat dapat menandakan adanya kanker ovarium.
Tinjauan pustaka mengenai trombositopenia pada demam berdarah dengue membahas mekanisme penyebabnya yaitu supresi sumsum tulang, aktivasi dan destruksi trombosit oleh virus, serta disfungsi trombosit. Pemeriksaan jumlah trombosit penting untuk diagnosis dan pemantauan, dapat dilakukan secara manual maupun otomatis. Terapi trombositopenia meliputi transfusi trombosit dalam kondisi tertentu.
Thrombelastography (TEG) adalah tes koagulasi yang dilakukan di samping pasien untuk mengukur berbagai parameter koagulasi dalam 30 menit. TEG dapat digunakan untuk memantau koagulasi pada operasi jantung dan transplantasi hati serta mendeteksi gangguan koagulasi pada pasien trauma.
Tinjauan pustaka ini membahas patogenesis, diagnosis, dan klasifikasi paroxysmal nocturnal hemoglobinuria (PNH). PNH disebabkan oleh mutasi gen PIG-A yang mengakibatkan defisiensi protein yang terikat pada permukaan sel seperti DAF dan CD59. Ini menyebabkan aktivasi komplemen yang berlebihan dan hemolisis. Diagnosis didasarkan pada tes komplemen seperti sucrose lysis test dan flow sitometri untuk mengukur defisiensi CD55 dan CD59. PNH dik
Dokumen tersebut memberikan informasi mengenai prosedur hitung jenis lekosit secara manual dan otomatis. Secara manual melibatkan pembuatan hapusan darah, pewarnaan, dan perhitungan secara visual di bawah mikroskop. Secara otomatis menggunakan berbagai metode seperti impedansi, scatter cahaya, dan fluoresensi untuk menghitung dan membedakan jenis lekosit dengan lebih cepat dan akurat. Kedua metode memiliki kelebi
Dokumen tersebut memberikan ringkasan singkat tentang pemeriksaan Prothrombin Time (PTT) dan Activated Partial Thromboplastin Time (APTT) secara otomatis. Pemeriksaan ini digunakan untuk menilai fungsi koagulasi melalui jalur ekstrinsik, intrinsik, dan bersama dengan mengukur waktu pembekuan plasma menggunakan metode cahaya tersebar.
Dokumen tersebut memberikan penjelasan singkat tentang penggunaan alat otomatis Sysmex XE-2100 untuk pemeriksaan darah lengkap (CBC). Alat ini menggunakan teknologi kombinasi impedansi listrik dan aliran sitometri untuk menghitung parameter darah seperti eritrosit, leukosit, trombosit, hemoglobin, dan lainnya. Dokumen juga menjelaskan prinsip kerja, komponen utama, dan interferensi sampel yang dapat mempengaruhi
Dokumen tersebut memberikan penjelasan tentang pengecatan sitokimia pada leukemia yang dapat membantu diagnosis dan klasifikasi tipe leukemia. Beberapa metode pengecatan yang dijelaskan antara lain mieloperoksidase, sudan black, PAS, LAP, dan nonspesifik esterase, beserta prinsip, reagen, dan interpretasi hasilnya.
16. Pemeriksaan laboratorium MCV Hapusan Darah Tepi Vitamin B₁₂ serum Folat serum dan eritrosit Methylmalonic acid (MMA) dan homocysteine Antibodi antiparietal cell dan anti IF Tes Schilling 12
17. Mean Corpuscular Volume (MCV) MCV > 100 fL Penyebab makrositosis : Megaloblastik atau non megaloblastik MCV meningkat sebelum terjadi penurunan kadar Hb. Bila defisiensi vitamin B₁₂ bersamaan dengan defisiensi besi MCV normal MCV kurang spesifik 13
18. Oval makrosit kesan penyakit megaloblastik Stomatosit dengan makrosit alkoholism Hipersegmentasi sensitif dan spesifik untuk anemia megaloblastik Hapusan darah tepi 14
19. Vitamin B₁₂ serum Digunakan untuk diagnosis dan monitoring terapi defisiensi vitamin B₁₂ Batas bawah normal biasanya sekitar 148 pmol/L (200 pg/mL) Belum ada baku emas sensitivitas dan spesifisitasnya bervariasi lebar. Metode pemeriksaan : automated non-isotopic procedure menggunakan chemiluminescence 15
20. Lanjutan vitamin B₁₂ serum.... Pada gagal ginjal vitamin B₁₂ serum tinggi Defisiensi vitamin B₁₂ pada penderita penyakit mieloproliferatif, gangguan ginjal/liver kadar vitamin B₁₂ bisa normal/tinggi Kolonisasi bakteri usus tinggi palsu 16
21. Folat serum dan folat eritrosit Batas bawah normal folat serum : 6,8 nmol/L Kadar folat serum dipengaruhi diet. Kadar folat eritrosit lebih mencerminkan simpanan folat jaringan. Belum ada metode baku emas 17
22. Methylmalonic acid (MMA) dan homocysteine Defisiensi vitamin B₁₂ MMA dan homocysteine Defisiensi folat homocysteine MMA dan homocysteine sensitif untuk diagnosis defisiensi vitamin B₁₂ Hati-hati interpretasi peningkatan metabolit bila tanda-tanda defisiensi (-) Setelah 7-14 hari pemberian terapi kadar metabolit menjadi normal 18
24. Antibodi anti sel parietal dan anti Intrinsic Factor (IF) Antibodi anti sel parietal : Non spesifik Terdapat pada penderita autoimun, orang sehat Antibodi anti IF : Tidak sensitif, namun cukup spesifik, walaupun masih mungkin ada pada penderita Graves disease. 20
25. Tes Schilling Untuk konfirmasi gangguan absorbsi vitamin Terdiri dari 2 tahap : 21
36. Tabel 6. Evaluasi penderita dengan kelainan hematologi dan vitamin B₁₂ <74 pmol/L 25
37. Gbr. 8. Evaluasi penderita yang diduga defisiensi vitamin B₁₂ dengan CBC normal 26
38. Diagnosis defisiensi vitamin B₁₂ dan folat hal yang kompleks. Belum ada tes yang mudah sebagai baku emasnya Perlu integrasi hasil laboratorium, klinis, respon terapi 27
40. 29 Gambar 6. Prinsip Beckman ACCESS Immunoassay System untuk pengukuran Vitamin B12. Serum.5
41. 30 Treatment B12 can be supplemented in healthy subjects by oral pill; sublingual pill, liquid, or strip; intranasal spray; or by injection. B12 is available singly or in combination with other supplements. B12 supplements are available in forms including cyanocobalamin, hydroxocobalamin, methylcobalamin, and adenosylcobalamin (sometimes called "cobamamide" or "dibencozide"). Oral treatments involve giving 250 ug to 1 mg of B12 daily.[28] Vitamin B12 can be given as intramuscular injections of hydroxycobalamin, methylcobalamin, or cyanocobalamin. Body stores (in the liver) are refilled with half a dozen injections in the first couple of weeks and then maintenance with monthly to quarterly injections throughout the life of the patient. B12 has traditionally been given parenterally to ensure absorption. However, oral replacement is now an accepted route, as it has become increasingly appreciated that sufficient quantities of B12 are absorbed when large doses are given. This absorption does not rely on the presence of intrinsic factor or an intact ileum. Generally 1 to 2 mg daily is required as a large dose [3]. By contrast, the typical Western diet contains 5–7 µg of B12 (Food and Drug Administration (FDA) Daily Value [29]).
44. 33 Hematological findings The blood film can point towards vitamin deficiency: Decreased red blood cell (RBC) count and hemoglobin levels[citation needed] Increased mean corpuscular volume (MCV, >95 fl) and mean corpuscular hemoglobin (MCH) Normal mean corpuscular hemoglobin concentration (MCHC, 32-36 g/dL) The reticulocyte count is decreased due to destruction of fragile and abnormal megaloblastic erythroid precursor. The platelet count may be reduced.[citation needed] Neutrophil granulocytes may show multisegmented nuclei ("senile neutrophil"). This is thought to be due to decreased production and a compensatory prolonged lifespan for circulating neutrophils, which increase numbers of nuclear segments with age.[citation needed] Anisocytosis (increased variation in RBC size) and poikilocytosis (abnormally shaped RBCs). Macrocytes (larger than normal RBCs) are present. Ovalocytes (oval-shaped RBCs) are present. Howell-Jolly bodies (chromosomal remnant) also present. Blood chemistries will also show: In increased lactic acid dehydrogenase (LDH) level. The isozyme is LDH-2 which is typical of the serum and hematopoetic cells. Increased homocysteine and methylmalonic acid in B12 deficiency Increased homocysteine in folat
53. 41 Vitamin B12 Analogues Vitamin B12 is a coenzyme: it is needed for enzymes to do their job of changing one molecule into another. As vitamins go, B12 is large. One part of its structure is known as the corrin nucleus, which holds an atom of cobalt. The corrin resembles the heme of hemoglobin which holds an atom of iron. Any molecule that contains a corrin nucleus is considered a corrinoid. The corrin plus other atoms make up the cobalamin part of B12. There are many different cobalamins and they are named after their attachments. For example, methylcobalamin is cobalamin with a methyl group (one carbon and three hydrogens) attached. All corrinoids (including all cobalamins) are considered B12 analogues. Many corrinoids, and possibly even some cobalamins, are not useable by human B12 enzymes. These are considered inactive B12 analogues.
54. Vitamin B12 Deficiency homocysteine and methylmalonyl CoA Increase in methylmalonyl CoA Increased enzyme activity in fatty acid synthesis Build up of odd fatty acids around peripheral nerves Increase in homocysteine Vascular/nervous problems
82. 57 Methylmalonic acid (MMA) is a dicarboxylic acid that is a C-methylated derivative of malonate. Pathology Increased methylmalonic acid levels may indicate a vitamin B12 deficiency. However, it is sensitive without being specific. MMA is elevated in 90-98% of patients with B12 deficiency. This test may be overly sensitive, as 25-20% of patients over the age of 70 have elevated levels of MMA, but 25-33% of them do not have B12 deficiency. For this reason, MMA is not routinely recommended in the elderly. [1] An excess is associated with methylmalonicacidemia. MMA concentrations in blood are measured by Gas chromatographicMass spectrometry
83. 58 Folic acid and vitamin B12Large amounts of folic acid can mask the damaging effects of vitamin B12 deficiency by correcting the megaloblastic anemia caused by vitamin B12 deficiency [3,5] without correcting the neurological damage that also occurs [1,31]. Moreover, preliminary evidence suggests that high serum folate levels might not only mask vitamin B12 deficiency, but could also exacerbate the anemia and worsen the cognitive symptoms associated with vitamin B12 deficiency [6,11]. Permanent nerve damage can occur if vitamin B12 deficiency is not treated. For these reasons, folic acid intake from fortified food and supplements should not exceed 1,000 mcg daily in healthy individuals [5].
84. Diet Methyltetrahydrofolate Vitamin B12 Methionine Methyl B12 Homocysteine CH3 tetrahydrofolate Serine Dihydrofolate Purine and pyrimidine synthesis + B6 DNA Glycine Thymidylate Deoxyuridylate 5,10 methylenetetrahydrofolate Gambar 4. Jalur metabolik asam folat dan vitamin B12.2. 59
119. 63 The present invention relates to a new method named the COBASORB test, which can be used for testing the cause of cobalamin malabsorption in humans. The COBASORB test contains three separate tests (first, second and third test) than can be performed separately, sequentially or in random order and number. The first test use non-radioactive cobalamin for ingestion, the second test uses non-radioactive cobalamin and recombinant intrinsic factor for ingestion and the third test uses recombinant haptocorrin saturated with cobalamin for ingestion. All three tests involve analysis of changes in the concentration of cobalamin saturated transcobalamin (holo-TC) and cobalamin saturated haptocorrin (holo-HC) in the blood. Also disclosed are fits suitable for use in these methods.
120. 64 Salivary haptocorrin, also known as the R-protein, binds strongly to Vitamin B12 (after it is released from food by gastric pepsin), stabilizing it and preventing its breakdown in the low-pH environment of the stomach. The complex is absorbed by ilealvilli into the blood. HC accounts for 10-40% of B12 serum level.