Macrocyctic Anemia Intro

[@MedicosisPerfectionalis]

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[@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.

[@sameer-zk2jn]

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

[@MedicosisPerfectionalis]

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

[@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

[@queenbeequeenb9]

Thnx

[@giridhar3000]

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

[@MedicosisPerfectionalis]

Thank you 🙏

[@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:)

[@Dentalmasterychannel]

Your videos are justttt amazing watching them for my exam

[@MedicosisPerfectionalis]

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

[@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!

[@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

[@noumanmajeed6266]

Azathioprurine, cyclophaphamide, flurouracil, cytarabine, mercaptopurine

[@MedicosisPerfectionalis]

Great!

[@mosesalexander225]

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

[@MedicosisPerfectionalis]

Glad you liked that! Thanks

[@leavinoneday]

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

[@MedicosisPerfectionalis]

I appreciate you so much!

[@kunmunnayak3575]

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 😁

[@kunmunnayak3575]

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

[@malissacampbell634]

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

[@MedicosisPerfectionalis]

You’re very welcome 😊

[@Choogaleh]

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

[@MedicosisPerfectionalis]

Awesome 👏....Good luck to you!

[@email1123]

I love how you always draw the patient/people with huge foreheads lol keep up all the good work that you do. Thank u!

[@MedicosisPerfectionalis]

You’re very welcome 😊

[@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!

[@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.

[@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.

[@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

[@veroverdino]

"that makes sense"

[@MedicosisPerfectionalis]

Indeed! Thanks for watching!

[@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.

[@user-qr4te5pv7e]

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

[@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!

[@laptopfamily-tj9uc]

thank you for existing

[@MedicosisPerfectionalis]

I appreciate you!

[@drvictorious1387]

Your videos are making my mind to apply for mrcpath 😅

[@MedicosisPerfectionalis]

I wish you all the best!

[@imanbakk3138]

I love your voice OMG thanks alot

[@MedicosisPerfectionalis]

My pleasure!

[@jabizebadi6982]

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

[@emanali9010]

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

[@MedicosisPerfectionalis]

Thank you so much 😊

[@millicentmmuwomba1850]

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

[@MedicosisPerfectionalis]

My pleasure 😇

[@ayuniakainya4620]

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

[@user-nt5iv8gl4i]

Thank you, you make things so easy for us.

[@MedicosisPerfectionalis]

My pleasure 😇

[@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

[@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'❤️

[@FAM648]

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

[@MedicosisPerfectionalis]

Thank you!

[@swatibhatt552]

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

[@mariya5605]

Duodenum &jejunum absorbs folate

[@MedicosisPerfectionalis]

Excellent.
Especially jejunum

[@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!

[@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]

😁😁😁😁😄

[@AU-yx5gn]

the intro was much needed 😭

[@MedicosisPerfectionalis]

:)

[@loumartinq]

i have been watching you videos recently thx

[@MedicosisPerfectionalis]

My pleasure 😇

[@carolinepate2119]

love the intro xD

[@MedicosisPerfectionalis]

Glad to hear that! Thanks a ton!

[@Weirdandwacky1028]

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

[@MedicosisPerfectionalis]

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

[@jennyblight4039]

Methotrexate depletes folate and therefore causes macrocutic anaemia

[@ocots]

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

[@sadie7617]

You're so awesome thank you so much

[@hadianasim4575]

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

[@ibtesamawad746]

You made my day! 💙

[@MedicosisPerfectionalis]

Thank you so much 😊

[@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!

[@fatimasuleman1980]

Thank you so much. You are really awesome 😊😊

[@MedicosisPerfectionalis]

Thanks a lot!

[@user-by8zu5ob9h]

I like you're way of explain !!!

[@darkblue1423]

Wallah THE BESTTTT!!!😍

[@h.medicine9119]

thank you soooooooooooooooooooo much

[@gsilawat]

Very very nice thank you so much

[@MedicosisPerfectionalis]

My pleasure 😇

[@anjalianjan4643]

Love ur explanation✌

[@MedicosisPerfectionalis]

Cool...I am honored!

[@mariaalexandraflorea6520]

metformin is also imparing b12 absorbtion

[@noname-ry3ln]

THE BEST OF BEST

[@MedicosisPerfectionalis]

Thanks a ton!

[@reem4890]

I love you medicosis

[@MedicosisPerfectionalis]

Thank you ☺️

[@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”

[@vaibhavsaini6522]

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

[@MedicosisPerfectionalis]

My pleasure 😇

[@laila1483]

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

[@saralissali1090]

Thank u doctor proud of you

[@sujanbhattarai3698]

Normal mcv but high mchc ? What does this mean

[@raminbarzani8977]

Ohh it really makes sense now

[@madhukardeshpande563]

Thanks for explanation

[@MedicosisPerfectionalis]

You’re always welcome 🙏

[@newbox2178]

Thank you so much, very helpful

[@MedicosisPerfectionalis]

You’re welcome 😇

[@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)?

[@rockycycle2682]

5 Flourouracil

[@shikhavats7898]

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

[@homoeoscience139]

Thank you very much

[@sofiaahmed3872]

2020/9/2

[@naluh_n]

I love it here🥺❤

[@MedicosisPerfectionalis]

Thank you 🙏

[@shuhaibsaidumohamed6854]

jejunum and caogulase

[@MedicosisPerfectionalis]

Yup 👍👍

[@wilsonkaseha2034]

Perfect!

[@MedicosisPerfectionalis]

Thank you so much, Sir!

[@mounia1mimi281]

Thank you

[@drskavitha1285]

methotrexate, trimethoprim sulfomethoxazole

[@MedicosisPerfectionalis]

👍

[@karisatsofwa9708]

Sodium valproate, Phenytoin

[@emanuele2398]

Thank you medicosis

[@MedicosisPerfectionalis]

My pleasure 😇

[@umarkhader7313]

u r the best

[@MedicosisPerfectionalis]

Thanks, brother!

[@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 😘

[@savingpeace8452]

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

[@mutsawashe3607]

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

[@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.

[@sanariax]

Trimethoprim, phenytoin, methotrexate

[@zainabhassan7905]

Nice explanation ❤

[@MedicosisPerfectionalis]

Thank you so much 😊

[@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

[@rabiaqayyyum3444]

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

[@jaysoncaliba3054]

What do you mean by macrocytosis with normoblastic view?

[@aubioxo]

so what type of drugs causes that ?

[@ahmedabdalazeez6716]

Duodenum and upper jejunum

[@majchrzak210643]

Zidovudine (NRTI)

[@ahmadhammad3769]

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

[@MommaBearsCorner]

?

[@e.d.l.nisansala7858]

Duodenum and jejunum..

[@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???

[@InTheStrangersEyes8]

Tq 🙏😊

[@MedicosisPerfectionalis]

My pleasure

[@sanariax]

Methotrexate, phenytoin, zidovudine

[@omarjana1920]

MTX

[@ankitashinchan6289]

Thnkuu very much

[@MedicosisPerfectionalis]

My pleasure 😇