Folic Acid (Vitamin B9) Deficiency

WHAT IS IT?

Folic acid (vitamin B9) deficiency is a fairly self explanatory term. 

WHAT CAUSES IT?

Various processes can be responsible for a folic acid deficiency:

  • Dietary deficiency: individuals with poor intake of folic acid containing foods (such as alcoholics) can develop this condition. 
  • Medication side effects: medications like phenytoin may make it more difficult to absorb folic acid intestinally. 
WHY IS IT CONCERNING MEDICALLY?

Folic acid is an important that is required for DNA synthesis. Its absence can lead to the following types of medical complications:

  • Megaloblastic anemia: folic acid deficiency can directly cause this type of anemia (through compromised DNA synthesis in RBCs). 
WHAT IS THE INTIAL PRESENTATION?

Patient Chief Complaints:

 

Detected Medical Problems:

  • Megaloblastic anemia 
WHAT ARE IMPORTANT ELEMENTS OF THE MEDICAL HISTORY?

Risk Factors:

  • Alcoholism 
  • Phenytoin usage

Medical History:

 

WHAT ARE IMPORTANT FEATURES OF THE PHYSICAL EXAM?

Vital Signs:

 

General Appearance:

  • Pallor may be present in patients with more severe anemia 
CLINICAL WORKUP: SERUM STUDIES

Complete Blood Count (CBC):

  • Decreased hemoglobin/hematocrit can be present 
  • Increased MCV is often seen in this deficiency. 
 
CLINICAL WORKUP: OTHER

 

HOW DO WE NARROW THE DIFFERENTIAL?

Conditions that present similarly and how to exclude them:

 

WHAT IS OUR THRESHOLD FOR DIAGNOSING THIS CONDITION?

 

PATIENT MANAGMENT: SYMPTOM RELEIF

 

PATIENT MANAGEMENT: DISEASE TREATMENT

 

PATIENT MANAGEMENT: PROPHYLACTIC MEASURES

 

COULD THIS HAVE BEEN PREVENTED?

 

ARCHIVE OF STANDARDIZED EXAM QUESTIONS 

This archive compiles standardized exam questions that relate to this topic.

 

Page Updated: 02.22.2017