MEGALOBLASTIC ANEMIA

CAUSED BY:
 Deficiency of vitamin B12 (or) folic acid. Red bone marrow
produces abnormal RBC.
CLINICAL MANIFESTATIONS:
Symptoms of anemia:
 Fatigue and loss of energy
 Unusually rapid heart beat, particularly with exercise
 Shortness of breath and headache, particularly with exercise
 Difficulty concentrating
 Dizziness
 Pale skin
 Leg cramps
 Insomnia.
 DIGNOSTIC TESTS
 Schilling test:

 The patient receives a small oral dose of radioactive

vitamin B12 then after few hours large, non radioactive
parenteral dose of vitamin B12.
 8% is excreted in the urine within 24 hours.
Therefore if no radioactivity is present the cause is GI
malabsorption of the vitamin B12.
 MANAGEMENT
MEDICAL MANAGEMENT:
 1mg folic acid daily in diet.
 Monthly IM injections of vitamin B12.
 Orally: 2mg /day of vitamin B12.

NURSING MANAGEMNT:
 Inspect skin, mucous membranes and tongue.
 Advice the patient eat small amount of bland and soft foods
frequently.
 A nurse should explain other nutritional deficiencies such as
alcohol-induced anemia which can leads to neurological
problems.