Haem: Macrocytic Anaemia: Free MSRA Podcast

🎧 MSRA Podcast: Macrocytic Anaemia – Big Red Flags for Your Revision! 🎧Ever feel wiped out for no good reason? Let’s get real: sometimes it’s not “just a busy week”—sometimes your red blood cells are trying to tell you something. In this focused deep dive, we break down exactly what you need to know about macrocytic anaemia for your MSRA revision.DefinitionMacrocytic anaemia = big (macro) red cells + low haemoglobin.Two main types: megaloblastic (nuclear-cytoplasmic asynchrony, usually B12/folate deficiency) and non-megaloblastic (no asynchrony—think alcohol, liver disease, hypothyroidism, drugs).Causes (How to Remember):BF twins:B12 deficiencyFolate deficiency (diet, absorption, increased need/pregnancy, drugs)LAHRA:Liver diseaseAlcoholHypothyroidism (severe)Reticulocytosis (lots of young red cells)Azathioprine & other meds, bone marrow disordersRisk Factors:Elderly (especially B12), strict vegans (no B12 unless supplemented), GI diseases (Crohn’s, coeliac, post-gastric surgery), chronic alcohol use, long-term meds (methotrexate, phenytoin), autoimmune history (pernicious anaemia).Pathophysiology:Impaired DNA synthesis = slow-maturing nuclei, “big clumsy” red cells.Megaloblastic = B12/folate deficiency.Non-megaloblastic = cell membrane changes (liver, alcohol, etc).Symptoms & Signs:Fatigue, pallor, breathlessness, dizzinessB12 deficiency = add “tongue and tingles” (glossitis, neuropathy, balance problems)Often subtle/insidious—may just see a high MCV on bloods!Diagnosis:Start: FBC (high MCV = macrocytosis, low Hb = anaemia)Next: B12 and folate levels, peripheral blood smearExtras: LFTs (alcohol/liver), reticulocyte count, intrinsic factor antibodies (if suspecting pernicious anaemia), homocysteine/methylmalonic acid, bone marrow if needed.Management:Treat the cause:B12 deficiency = IM B12 (lifelong if pernicious or malabsorption)Folate deficiency = oral folic acid (but treat B12 first if both are low!)Manage underlying issues: alcohol cessation, manage liver/thyroid/haematological disordersRefer: urgent haematology (neuro signs, pregnancy, unclear cause), urgent gastro (suspect gastric cancer/coeliac), dietitian (poor diet)Complications (if missed!):Irreversible neurological damage (B12)Heart failure (severe/prolonged anaemia)InfectionsPregnancy: neural tube defects (folate deficiency)Macrocytic Anaemia Revision Notes:https://www.passthemsra.com/topic/macrocytic-anaemia-revision-notes/Flashcards:https://www.passthemsra.com/topic/macrocytic-anaemia-flashcards/Accordion Q&A Notes:https://www.passthemsra.com/topic/macrocytic-anaemia-accordion-qa-notes/Rapid Quiz:https://www.passthemsra.com/topic/macrocytic-anaemia-rapid-quiz/Online Quiz:https://www.passthemsra.com/quizzes/macrocytic-anaemia/#MSRA #MacrocyticAnaemia #Haematology #MSRARevision #PassTheMSRA #MSRAQuiz #MedStudentLifeExam Pearl:Always think: BF and LAHRA.Suspect macrocytic anaemia? Never forget to check B12/folate and dig for the cause—don’t let those subtle neuro signs slip by!🗝️ Key Learning Points📝 Revision Resources