Clinical haematology · UKMLA & AKT
Megaloblastic anaemia (B12 and folate deficiency)
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Megaloblastic anaemia - macrocytic anaemia from impaired DNA synthesis due to B12 or folate deficiency
- Both required for DNA synthesis → cells grow but cannot divide → oval macrocytes + hypersegmented neutrophils on film
- B12 also required for myelin synthesis (methylmalonyl-CoA → succinyl-CoA) - neurological complications exclusive to B12 deficiency
Always replace B12 before folate when both are deficient. Giving folic acid first corrects the anaemia but allows neurological damage from B12 deficiency to progress - potentially causing irreversible subacute combined degeneration of the cord. Think: B before F.
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