Case Study:


A 47-year-old female is brought to the emergency department with complaints of malaise (discomfort), nausea, vomiting, and fatigue. The patient revels a long history of alcohol abuse. She has been to rehab on several occasions for alcoholism but has not been able to stop drinking. She is currently homeless and jobless. She denies cough, fever, chills, upper respiratory symptoms, contact with sick people, recent travel, or abdominal pain. She reports feeling hungry and has not eaten very well in a long time. On physical exam she appears malnourished but in no distress. Her physical exam is normal. Her blood count reveals a normal white blood cell count but does show an anemia with large red blood cells. Her amylase, lipase and liver function tests were normal.


1. What is the most likely cause of her anemia??


            Folic Acid deficiency





2. Define the following terms:




Refers to RBC division and more specifically a lack of the “hematopoietic” vitamins results in reduced RBC division and leads to anemia





            Folic Acid:


Required: for the synthesis of pyrimidines in DNA ----> RBC division

Function: carrier of one carbon units (i.e. methyl transfer reactions)

Source: nearly all foods.

Supplements: prescribed during pregnancy to reduce the incidence of neural tube defects in newborns.



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