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Anaemia – B12 and Folate Deficiency (P)
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Course Curriculum
1. What is the most common cause of vitamin B12 deficiency in the UK?
*
Iron-deficient diet
Pernicious anaemia
Excessive alcohol intake
Coeliac disease
2. Which of the following symptoms is most characteristic of B12 deficiency?
*
Chest pain
Constipation
Peripheral neuropathy
Rash
3. What blood film finding is typically seen in B12 or folate deficiency?
*
Microcytic hypochromic cells
Spherocytes
Target cells
Macrocytic red blood cells
4. Which of the following is a neurological complication of B12 deficiency?
*
Spastic paraparesis
Subacute combined degeneration of the spinal cord
Bell’s palsy
Migraine
5. Which test confirms the presence of intrinsic factor antibodies?
*
Schilling test
Serum ferritin
Anti-intrinsic factor antibody assay
Serum methylmalonic acid
6. Which oral supplement is commonly prescribed in folate deficiency?
*
Cyanocobalamin
Folic acid
Ferrous fumarate
Vitamin
7. What is a key dietary source of vitamin B12?
*
Spinach
Bananas
Meat and dairy products
Citrus fruits
8. Which condition commonly coexists with folate deficiency?
*
Hypertension
Chronic alcohol misuse
Gastro-oesophageal reflux
Diabetes insipidus
9. In which patient group is folate supplementation particularly important?
*
Postmenopausal women
Pregnant women
Elderly men
Children under 5
10. How is B12 usually replaced in patients with confirmed pernicious anaemia?
*
Oral B12 tablets daily
Fortified cereal intake
Intramuscular hydroxocobalamin
Sublingual B12 spray
11. Which investigation helps distinguish between folate and B12 deficiency?
*
MCV
Serum ferritin
Serum methylmalonic acid and homocysteine
Platelet count
12. Why is it important to check B12 status before starting folate therapy?
*
To save costs
To avoid masking neurological symptoms
To improve absorption
Because folate inhibits B12
13. Which of the following drugs can contribute to folate deficiency?
*
Paracetamol
Methotrexate
Atorvastatin
Metformin
14. What haematological parameter is commonly elevated in B12 deficiency?
*
MCV
Platelet count
Haematocrit
RDW
15. What is the typical frequency of hydroxocobalamin injections in maintenance therapy?
*
Weekly
Every 3 months
Daily
Twice a year
16. Which of these symptoms would prompt urgent investigation for B12 deficiency?
*
Memory loss and paraesthesia
Glossitis
Fatigue alone
Conjunctival pallor
17. Which gastrointestinal surgery can increase risk of B12 deficiency?
*
Appendectomy
Colectomy
Cholecystectomy
Gastrectomy
18. What is the main reason for poor absorption of B12 in pernicious anaemia?
*
Iron overload
Loss of intrinsic factor
Low dietary intake
Pancreatic insufficiency
19. Which symptom is least typical in folate deficiency?
*
Fatigue
Neural tube defects in foetus
Mouth ulcers
Peripheral neuropathy
20. Which dietary group is more likely to develop B12 deficiency?
*
Vegetarians
Meat eaters
Pescatarians
Ketogenic diet followers