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B12_Folic_Acid_Deficiency_Anemia__RC - Learning Issue B12...

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Learning Issue: B 12 and Folic Acid Defiency in Relation to Anemia Name: Rachel Chacko Definition: A deficiency of vitamin B 12 or folic acid is usually suspected in the presence of a megaloblastic anemia, one type of macrotcytic (MCV > 100 fL) anemia. Hematologic picture is identical for folate deficiency and B 12 deficiency. Normal Range: The reference range for vitamin B 12 is often listed as 200 to 900 pg/ml but now, patients with levels less than 300 pg/ml are recognized as having a deficiency. Folate levels about 4ng/mL are considered normal and levels of 2-4 ng/ml are indeterminate. A person in negative folate balance will become serum deficient before tissue folate stores decrease; therefore, a low serum folate level indicates a negative folate balance, but not necessarily tissue folate deficiency. Serum folate levels should be determined before a hospitalized patient is fed or given a transfusion. Diagnostic Tests/Results: Peripheral blood smear typically shows the presence of oval macrocytes and hypersegmented neutrophiles. Size variation (anisocytosis) and
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