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Algorithm for the evaluation of macrocytic anemia. (RBC = red blood cell; MMA = methylmalonic acid.)
Physicians
evaluation of macrocytic ... the most likely cause ... recovery also causes ... B12 deficiency ... deficiency.
Clinically Important Vitamins and Vitamin Deficiency States
Fat-soluble Vitamins: 
 • Vitamin A - Xerophthalmia, night blindness,
Clinically Important ... Deficiency States ... • Thiamine B1 ... B12 - Anaemia, ... #Deficiency #differential
Micronutrient Deficiencies After Gastric Bypass
Fat-Soluble Vitamins:
 • Vitamin A - Night/complete blindness, xeropthalmia (pathologic dryness of
• Thiamine - Nausea ... oculomotor dysfunction, gait ... anemiaVitamin ... B12 - Macrocytic ... nutrition #table #differential
Diagnostic Framework for Anemia (Morphological Approach - MCV)
Low MCV - <80fL - "Microcytic"
 • Iron deficiency
MCV - >96fL - "Macrocytic ... Megaloblastic: Vitamin ... B12 deficiency, ... morphologic #mcv #differential ... #diagnosis #causes
Approach to Hypoproliferative Macrocytic Anemia

 • 812, Folate Deficiency
 • MDS+
 • Hypothyroid
 • Liver Disease
Hypoproliferative Macrocytic ... Anemia812 ... , Folate Deficiency ... #Anemia #differential ... algorithm #hematology #workup
Causes of Anemia with elevated Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm
Normal Blood Smear
 •
Causes of Anemia ... Volume (MCV) - Differential ... • Drugs Oval Macrocytes ... • Dietary Deficiency ... and Folate Deficiency
Causes of Vitamin B12 Deficiency - Cobalamin
Decreased Intake
Pancreas: Insufficiency
Intestine: SIBO, Celiac disease, IBD, Lymphoma, Amyloidosis, Resection,
Causes of Vitamin ... B12 Deficiency ... Stomach: Pernicious anemia ... #B12 #Deficiency ... #Cobalamin #differential
Anemia - Underproduction Diagnostic Algorithm
 - Iron deficiency anemia
 - Anemia of chronic inflammation
 - Anemia
kidney disease - Vitamin ... B12 and/or folate ... deficiency - ... hematology #diagnosis #differential ... #workup
Red Blood Cell (RBC) Morphology
Microcytic RBC: Pyridoxine deficiency, Thalassemia, Iron deficiency anemia, Chronic disease anemia (sometimes),
RBC) Morphology Microcytic ... RBC: Pyridoxine deficiency ... (sometimes) Macrocytic ... RBC: Vitamin B12 ... RBC #Morphology #differential
Wernicke's Encephalopathy vs Korsakoff Syndrome - Thiamine Deficiency

Wernicke's encephalopathy is a neurological condition due to longstanding
B1) deficiency, ... ataxia (broad-based gait ... and retrograde amnesia ... #vitaminB1 #B1 # ... diagnosis #comparison #neurology