Macrocyctic Anemia Intro

[@MedicosisPerfectionalis]

💉 📜 50 hematology cases are waiting, as well as the answer to today's question...Go to www.patreon.com/medicosis/ 😅 If you like mnemonics, try Picmonic: www.picmonic.com/referrals/JK55NQXQQB9JLC119 👩‍💻Sign up for Dropbox here: db.tt/IIlB8ejxWe 📕📗 Books that I recommend, www.amazon.com/shop/medicosisperfectionalis

[@brandidonneforti1885]

I was told years ago that I have Macrocytosis caused by b12 and Folate acid Deficiency. I am always extremely tired and fatigue, Last year I got blood work done and my MCV Levels were high. What can I do to cure this? What can I do to help me feel less tired?

[@MedicosisPerfectionalis]

Please talk to your doctor to know the cause of the underlying problem.

[@deepakkumargupta9511]

folates are absorbed in jejunal cells

[@deepakkumargupta9511]

i think drugs(pyrimethamine,primaquinine ,5 FU ) are the cause of macrocytic with megaloblasts,but u said it was macrocyte with non megaloblast . i am confussed .please clarify ..

[@md.sharifulislamswapon2685]

C

[@rathodnehal2869]

Dude Is Just Feeling Ill Bro Duodenum- Iron , Jejunum-Folate ,Ileum- B12 this mnemonic is not made by me but i copying but its really helpful 👍😊👍

[@MedicosisPerfectionalis]

That's a good mnemonic

[@astre935]

perfect

[@mnrkyc]

When I think about "Feeling" word I am just focusing to "Fe..." . Please forgive me 😂😊

[@prithvisenajas7156]

I have my 2nd year finals just after a month and i was completely clueless, crying, depressed until i found your channel. Thanks for lighting me up and motivating me to give whatever i got! Love you

[@MedicosisPerfectionalis]

That’s one of the best comments I have received recently...I am sure you will do fine, have a strong desire and write down a plan...and you will succeed...Best of luck!

[@prithvisenajas7156]

@@MedicosisPerfectionalis thanks

[@MedicosisPerfectionalis]

My pleasure!

[@comradejames451]

Agreed, old boy is now my favorite m.d.

[@MedicosisPerfectionalis]

Thanks 🙏

[@hadeelhassenaltalhi5365]

FOLATE: JEJUNUM, B12: ILIUM, IRON: DUODENUM

[@MedicosisPerfectionalis]

Excellent! You got it!

[@ranjamedi4717]

*ileum

[@user-qr4te5pv7e]

Folate antagonists (eg, methotrexate ) Purine antagonists (eg, 6-mercaptopurine [6-MP]) Pyrimidine antagonists (eg, cytosine arabinoside [ara-C]) Alkylating agents (eg, cyclophosphamide) Tyrosine kinase inhibitors (eg, sunitinib, and imatinib)

[@user-qr4te5pv7e]

Basically it seems that any oncology drug that interferes w/ cell cycle can cause macrocytosis.

[@elaineluther1799]

Folate is absorbed in the jejunum with the help of the enzyme folate hydrolase, located in the brush border.

[@mrabin8098]

i found it helpful thank you

[@khalildaoud671]

thx

[@maemai1011]

Thank u

[@giridhar3000]

hematology was a scary subject for me . these lectures will really help me a lot . thank you.

[@MedicosisPerfectionalis]

Thank you 🙏

[@MedicosisPerfectionalis]

🩸 Hematology Playlist: kzbin.info/aero/PLYcLrRDaR8_eoNz6dxXolh1XMEietcniU&si=tomFsUjAgOKhOJVq

[@sameer-zk2jn]

Tired & pale .Pale & tired😂 Love this line so much.Keep it up🙋

[@MedicosisPerfectionalis]

I am so delighted now :) Thanks, please share!

[@sanat.8601]

just in case, ur videos attract me to study ! i love the way how relaxed u r explainig such tough subjects !

[@MedicosisPerfectionalis]

Great insight...I try to stay relax in order to help me enjoy the subject!

[@sanat.8601]

@@MedicosisPerfectionalis u r awesome

[@MedicosisPerfectionalis]

You’re more awesome!

[@KCODacey]

Sana T. - I watch them for the same reason. I've been practicing medicine for 30 plus years. I found these videos this year & enjoy listening to them while driving back & forth to work & home, as well as while walking the dog. It's an enjoyable, informative way to pass the time. I would not wish to go back to my med school days but, if I did, I'd take Medicosis Perfectionalis along with me.

[@MedicosisPerfectionalis]

Kevin, you’re amazing! Thank you so much 😊 for your kind words:)

[@SarahE1005]

My dream job is a dr. I am currently in the process of being diagnosed and of course I've googled all my results. I'm not a medical student but these videos are great. Whoever you are you're great and funny too

[@MedicosisPerfectionalis]

Thank you so much 😊 Good luck to you! I wish you a speedy recovery!

[@mosesalexander225]

Love the way you explain terms by explaining their original greek/latin meanings. I do that too!

[@MedicosisPerfectionalis]

Glad you liked that! Thanks

[@IceDr4gonfly]

FIC is absorbed in the proximal intestine (Folate, Iron, calcium). B12 is absorbed in the distal intestine (ileum)

[@MedicosisPerfectionalis]

Folate is in the Jejunum

[@MommaBearsCorner]

then clearly i need to work on my intestine enzymes! low in them all. knew i found find answers on here. but waiting for doc also to see lab work. lol gotta learn whats going on today

[@malissacampbell634]

Answer: Distal portion of the ileum. thank you again! great videos

[@MedicosisPerfectionalis]

You’re very welcome 😊

[@Dentalmasterychannel]

Your videos are justttt amazing watching them for my exam

[@MedicosisPerfectionalis]

Thank you so much! I wish you all the best!

[@kunmunnayak3456]

I simply loved how u correlated all the stuff during that bit of folate absorption...❤ the video is great

[@MedicosisPerfectionalis]

I am so happy to hear that 😁

[@kunmunnayak3456]

@@MedicosisPerfectionalis all your anemia videos are awesome...thank you so much ❤❤😊

[@Qwerty3456]

Thank you so much In med school hematology was a difficult subject for me. Now its easy for me because of ur videos. Once again thank you

[@MedicosisPerfectionalis]

My pleasure 😇...You made my day!

[@Choogaleh]

Thanks for this video! I am self-studying and this helps with learning the material

[@MedicosisPerfectionalis]

Awesome 👏....Good luck to you!

[@ferashijazi1299]

NOW "everything is hunky-dory",...Thank you for all your Videos you are Awesome.

[@MedicosisPerfectionalis]

You’re even more awesome 😎...Please share my videos with others.

[@noumanmajeed6266]

Azathioprurine, cyclophaphamide, flurouracil, cytarabine, mercaptopurine

[@MedicosisPerfectionalis]

Great!

[@sophiebai5540]

i have a hematology exam next week ,and your videos helped a lot ,thank u

[@MedicosisPerfectionalis]

+Sophie Bai That’s why we are here! Good luck!

[@rofaidamamutuk9368]

Hi! You are explaining the concept in a concise manner, tackling the MUST KNOWS! And I thank you for that. I visited your site but don't have money to join. I just hope that watching your videos would help you via ads. :) Please don't stop making great videos. Soon, a lot will discover this channel. Oh, and btw, I am watching your videos in 1.5x speed. So for those complaining of your speed, you can just instruct them to do the same. :)

[@MedicosisPerfectionalis]

Hey! I am so grateful to you...Don’t worry about the website, just share my videos and that’s more than enough 😊...Plus there is nothing more satisfying to me than to help others struggle less with medical books 📚...Your comment means the world to me...Best of luck!

[@rofaidamamutuk9368]

​@@MedicosisPerfectionalis You are welcome! I can't help dropping these comments. Because after reading the mother books - physio, histo, biochem - patho - combined, I was dumbfounded to realize that have I watched your videos ahead, it would have been 10x easier for me to read those boring books. You give us a lighter version of Harper (biochem), tbh. Your work does not only help us medical students, but will also, inshaa Allah, could save thousands of patients ahead. God bless!

[@rofaidamamutuk9368]

@@MedicosisPerfectionalis Sure thing, I will share your videos! Kudos!

[@MedicosisPerfectionalis]

Thanks a ton 😊😊

[@sixstrm6542]

Lol I’m watching on 1.75

[@user-qr4te5pv7e]

So from a bichem standpoint, a B12 deficiency can present with homocystinemia as thrombosis, marfanoid appearance and downward lens subluxation.

[@user-qr4te5pv7e]

folates exist as polyglutamates and need to be enzymatically converted into folate monoglutamates by folate reductase in the jejunal mucosa in order to be absorbed.

[@leavinoneday]

Your channel is fun and helpfull!!! Love this hematology playlist Doc.

[@MedicosisPerfectionalis]

I appreciate you so much!

[@safilotra]

folate is absorbed by the mucosal cells of the jejunum and folate reductase inside these mucosal cells act on the folate to convert it into the mono form so it can be absorbed.

[@millicentmmuwomba1850]

Well explained,thank you for making life easier for us med students

[@MedicosisPerfectionalis]

My pleasure 😇

[@AU-yx5gn]

the intro was much needed 😭

[@MedicosisPerfectionalis]

:)

[@laptopfamily-tj9uc]

thank you for existing

[@MedicosisPerfectionalis]

I appreciate you!

[@imanbakk3138]

I love your voice OMG thanks alot

[@MedicosisPerfectionalis]

My pleasure!

[@veroverdino]

"that makes sense"

[@MedicosisPerfectionalis]

Indeed! Thanks for watching!

[@swatibhatt552]

it's Very helpful video watching from India thank you so much

[@emanali9010]

You are beyond good ... Thanks a ton ... Loads of good wishes and luck your way.. 😍😍😍

[@MedicosisPerfectionalis]

Thank you so much 😊

[@FAM648]

I love youuuuuu very much medcosis 💚💚💚💚💚💚💚

[@MedicosisPerfectionalis]

Thank you!

[@loumartinq]

i have been watching you videos recently thx

[@MedicosisPerfectionalis]

My pleasure 😇

[@albyrosecortez1780]

He sounds like this is the easiest thing in the world to understand and this is the millionth time he has had to explain it, I love it lmaooooo kept me laughing and listening

[@MedicosisPerfectionalis]

😁😁😁😁😄

[@تاكوالخالدي]

Thank you, you make things so easy for us.

[@MedicosisPerfectionalis]

My pleasure 😇

[@drvictorious1387]

Your videos are making my mind to apply for mrcpath 😅

[@MedicosisPerfectionalis]

I wish you all the best!

[@jabizebadi6982]

chemo (hydroxyurea), anti diabetics like sulfamids can cause macrocytic anemia

[@robertoconnell8153]

Im studying for the last final exam of my nursing program!! In nursing school they have done a really good job of teaching the macro view of medicine. However, I learned to connect concepts and understand how different pathologies are related from your videos. I felt like I had to thank you for all your help the last few years. What you do is SO important to people, thank you!

[@MedicosisPerfectionalis]

Wow 🤩 Thank you so much, Robert! I really appreciate you! Best of luck!

[@ayuniakainya4620]

Can B12 deficiency cause impaired folate absorption or folate deficiency? TIA

[@darkblue1423]

Wallah THE BESTTTT!!!😍

[@ocots]

Is the answer metformin? Cause it can inhibit B12 absorbtion?

[@vaibhavsaini6522]

I was actually desperate to listen to those first few words u said at the start of the video 😂, thanks 😁

[@MedicosisPerfectionalis]

My pleasure 😇

[@diptosusmay6179]

Hemolysis of magaloblasts occurs in where? Within bone marrow or within spleen? Davidson says it's within marrow, Btw you're the best of the bests'❤️

[@Weirdandwacky1028]

an excellent explaination....loved it....

[@MedicosisPerfectionalis]

This makes me super excited...Thanks for watching!

[@soumyadippal5568]

Even as a non medical student , I am able to understand almost 80 percent.... Though, I wanted to become a doctor... I have abc knowledge in biology

[@Mariaam902]

You made my day! 💙

[@MedicosisPerfectionalis]

Thank you so much 😊

[@hadianasim4575]

❤❤❤❤thanks makes it so much easy to understand.

[@fatimasuleman1980]

Thank you so much. You are really awesome 😊😊

[@MedicosisPerfectionalis]

Thanks a lot!

[@duaa7240]

so with vit. B12 deficiency we can have a "Hyperchromic" anemia right? since protein synthesis is not affected then Hb will continue to be synthesised and concentrate?

[@MedicosisPerfectionalis]

According to Harrison’s, when RBCs have more Hb, they become larger, not darker...Therefore, technically, there is no such thing as “hyperchromic”

[@عبقالزهور-ب8غ]

I like you're way of explain !!!

[@naluh_n]

I love it here🥺❤

[@MedicosisPerfectionalis]

Thank you 🙏

[@MommaBearsCorner]

have vitamin issues and labs came back. thanks for sharing. you and others here cleared up some things for me. and someone answers his question at end! lol >> Is absorbed primarily from the upper third of the small intestine. and i am not a student. haha

[@MedicosisPerfectionalis]

You’re very welcome! Best of luck to you!

[@anjalianjan4643]

Love ur explanation✌

[@MedicosisPerfectionalis]

Cool...I am honored!

[@laila1483]

So the methyl group holds the B12 from synthesizing DNA and this is what causes mutations in DNA?

[@noname-ry3ln]

THE BEST OF BEST

[@MedicosisPerfectionalis]

Thanks a ton!

[@user-qr4te5pv7e]

So non-megaloblastic anemia has all of the features of macrocytosis EXCEPT hypersegmented neutrophils? So this means you'll just see a big neutrophil with less than 5 lobes and big rbcs yet sx pt will px the same way (anemia, murmur, fatigue)?

[@shikhavats7898]

In jejunum part of the bowel folate become absorbed and enzyme responsible for it is folate reductase. Sir is it right ans ?

[@reem4890]

I love you medicosis

[@MedicosisPerfectionalis]

Thank you ☺️

[@saralissali1090]

Thank u doctor proud of you

[@gsilawat]

Very very nice thank you so much

[@MedicosisPerfectionalis]

My pleasure 😇

[@mariya5605]

Duodenum &jejunum absorbs folate

[@MedicosisPerfectionalis]

Excellent. Especially jejunum

[@sadie7617]

You're so awesome thank you so much

[@emanuele2398]

Thank you medicosis

[@MedicosisPerfectionalis]

My pleasure 😇

[@newbox2178]

Thank you so much, very helpful

[@MedicosisPerfectionalis]

You’re welcome 😇

[@mariaalexandraflorea6520]

metformin is also imparing b12 absorbtion

[@ocagri]

Can we see hypercellularity in bone marrow in megaloblastic anemia Excellent video!

[@MedicosisPerfectionalis]

Yes, it can happen!

[@veronicsohnamendy1195]

Yes of couse hypercellularity and hypersegmented neutrophil

[@zainabhassan7905]

Nice explanation ❤

[@MedicosisPerfectionalis]

Thank you so much 😊

[@ahmmadahmmad513]

Conjugas enzyme help to absorbed or jejunum

[@mutsawashe3607]

Anticovulsant drugs/antifolate drugs eg phenytoin cause non-megaloblastic anemia??

[@jaysoncaliba3054]

What do you mean by macrocytosis with normoblastic view?

[@صحتكبالدنيا-ظ6ث]

Can you please explain sympathatic and parasymphathtic and their effect on body ??

[@MedicosisPerfectionalis]

+Raneem Salem Sure! I will put it on my list. Thanks for your comment!

[@ahmedsalim8157]

Very nice and simple,thanks

[@MedicosisPerfectionalis]

My pleasure!

[@ahmadhammad3769]

Thanx sir😍 I have a question hope u answer Is macrocytic hypochromic anemia the characteristic of true vegetarian ?

[@MommaBearsCorner]

?

[@farahkhan7718]

Thank u so much that's another amazing video of ur's❤️..... I have got a question in my exam but I don't know it's answer.... Can u plz help me with this " differentiate between megaloblastic & pernicious anemia on the basis of microscopic pictures & red cell indices"?

[@MedicosisPerfectionalis]

Megaloblastic includes pernicious. That’s a weird question 🤷‍♂️

[@farahkhan7718]

@@MedicosisPerfectionalis yes I know it is.... I think only my professor knows it's answer😂.... Btw thank u so much for making such a great channel😊... U help me in my self studying during this time... & Thank u so much for always responding to my comments 😘

[@madhukardeshpande563]

Thanks for explanation

[@MedicosisPerfectionalis]

You’re always welcome 🙏

[@sujanbhattarai3698]

Normal mcv but high mchc ? What does this mean

[@umarkhader7313]

u r the best

[@MedicosisPerfectionalis]

Thanks, brother!

[@raminbarzani8977]

Ohh it really makes sense now

[@IVFRegulation]

"Bactrim Forte" cause non megaloblastic anemia, Isn't it?

[@mariamalmurad4955]

if there is DNA synthesis problem howcome RNA is normal ?

[@lubnaarshi5027]

Not synthesis exactly , the proper term would be maturation which has no relation to rna synthesis . In macrocytic anemia dna maturation lags behind cytoplasmic maturation, unlike in iron deficiency anemia where cytoplasmic maturation lags behind nuclear maturation . Hope this helps !!

[@nisarali9682]

Lubna will u plz elobrate it more???

[@bhaveshgarg8142]

which parkinson drud willl inhabit vitamin B6? you asked this qn in previous video . plzz someone tell the ans

[@MedicosisPerfectionalis]

L-dopa/carbidopa.

[@aubioxo]

so what type of drugs causes that ?

[@jennyblight4039]

Methotrexate depletes folate and therefore causes macrocutic anaemia

[@wilsonkaseha2034]

Perfect!

[@MedicosisPerfectionalis]

Thank you so much, Sir!

[@maarenst]

It’s not over 80 Femto per liter, it’s micrometer cubed

[@MedicosisPerfectionalis]

These 2 are equivalent!

[@h.medicine9119]

thank you soooooooooooooooooooo much

[@rabiaqayyyum3444]

😂 what was about pin and pan? "I am not good at pizzas" 😂

[@thameralamri5187]

excellent , but you need to add leukemia lectures

[@MedicosisPerfectionalis]

It’s coming...I will try my best to finish hematology and oncology as soon as possible! Thanks!

[@MedicosisPerfectionalis]

**GREAT NEWS!** My *leukemia* videos have started being uploaded...More than 10 oncology videos are exclusively available on my Patreon page NOW! www.patreon.com/medicosis. If you support me on Patreon, you can get early access to my videos before anyone else, plus, you get access to other notes, summaries and non-video content that I post on Patreon too.

[@homoeoscience139]

Thank you very much

[@talksick508]

Mch has always been elevated I also have mutated mthfr And I’m tired Pale Cold hands feet Fatigue Sleep issues Dryness in body eyes nose skin Hair falling out Heart palpitation Anxiety Flushing

[@talksick508]

Also dark bags eyes

[@MedicosisPerfectionalis]

What do you mean by dark bags eyes?

[@talksick508]

Medicosis Perfectionalis dark circles bags under my eyes

[@MedicosisPerfectionalis]

First:- I would like you to talk to your doctor and get some labs (CBC and thyroid function tests)...they help big time...”especially to rule out anemia and thyroid disease “ Please note: I am not a doctor, and making a diagnosis online is dangerous! Please see a doctor...and I truly wish you the best of luck!

[@talksick508]

Medicosis Perfectionalis thank u I was told years ago thyroiditis and took levothyroxine but lost so much weight she said stop med and thyroid is normal Doesn’t make sense I’ve been mystery 10 years They thought sjorgens thyroid no clue Mch is always high though

[@travelongshivangi3579]

How can I help to spread this channel??

[@MedicosisPerfectionalis]

Just share if you'd like! Thank you so much!

[@jilledmondson6894]

My doctors think azathiroprine (Imuran) and Orencia have caused my macrocytic anemia.

[@MedicosisPerfectionalis]

It’s possible! Your doctor knows your case, I don’t! Please talk to your doctor, or seek a second opinion! Good luck 🍀

[@savingpeace8452]

Why did I get this from fifth disease does anyone know?

[@MsMadamadamada]

I know metformin,sulfa drugs, anticonvulsants, antifolates and TMP-SMX but I have no idea about the mechanisms (apart from antifolate antagonists, it's clear lol) Read that sulfa drugs are competitive inhibitors of 4-aminobenzoic acid but that doesn't ring any bells. No idea about anticonvulsants, metformin or TMP-SMX. HELP GENIUS

[@MedicosisPerfectionalis]

I need more explanation. Can you phrase the question in a different way?

[@MsMadamadamada]

Yes sorry, rushed question (trying to binge watch your heme vids in a day lol). Drugs cause megaloblastic anemia. Sources say these are sulfonamides, metformin, TMP-SMX, anticonvulsants but I am having trouble with understanding the mechanisms as to why they cause it. Do you know? :)

[@drskavitha1285]

methotrexate, trimethoprim sulfomethoxazole

[@MedicosisPerfectionalis]

👍

[@karisatsofwa9708]

Sodium valproate, Phenytoin

[@aymanibrahim1646]

do u mean that macrocytes are big because they failed to divide?

[@MedicosisPerfectionalis]

Yes...There cytoplasm got bigger and was ready to divide, but the nucleus wasn’t ready due to folate deficiency, B12 deficiency,...etc.

[@aymanibrahim1646]

thanks a lot, i just love you 😭😤

[@MedicosisPerfectionalis]

Thank you so much ☺️

[@gsugguyufft1015]

I have that problem of anemia and I need help please 🙆

[@MedicosisPerfectionalis]

I am so sorry to hear that! What’s going on?

[@ashishpatel7876]

What’s hypochromic and hyperchromic

[@naluh_n]

Hypochromic is when RBC's have a low Hb....the RBC will present with a large central palor Hyperchromic is the opposite...high Hb content with no central palor and the RBC's are usually spherocytes

[@sanariax]

Trimethoprim, phenytoin, methotrexate