Clinical haematology · UKMLA & AKT
Megaloblastic anaemia
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise megaloblastic anaemia — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- B12/folate deficiency → reduced active tetrahydrofolate (THF) → impaired thymidylate synthesis → slowed DNA replication → nuclear-cytoplasmic dyssynchrony → megaloblasts + ineffective erythropoiesis
- B12 (only) also required for homocysteine → methionine → S-adenosylmethionine (SAM) → myelin synthesis; deficiency → demyelination of posterior and lateral spinal columns (subacute combined degeneration, SACD)
- Folate deficiency does NOT cause SACD - it does not affect this methylation pathway
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