MRCP UK EXAMINATIONS

NEUROLOGY

SURGERY

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
Name five substances that the bone marrow requires for normal erythrocyte production, and describe what can result if any of these factors are deficient.
A
Iron, vitamin B12, folic acid, pyridoxine, protein, and other factors are required. A deficiency of these factors during erythropoiesis can result in decreased red cell production.
B
The stroma is important in an indirect manner, in that it produces the colony-stimulating factors needed for hematopoiesis.
C
An intricate clotting mechanism is activated when necessary to seal any leak in the blood vessels. Excessive clotting is equally dangerous, because it can obstruct blood flow to vital tissues. To prevent this, the body has a thrombolytic (fibrinolytic) mechanism that eventually dissolves clots formed within blood vessels.
D
An increased number of band cells is sometimes called a left shift or shift to the left. A shift to the left indicates that more immature cells are present in the blood than normal.
Explanation: 

Detailed explanation-1: -Folate, vitamin B12, and iron have crucial roles in erythropoiesis. Erythroblasts require folate and vitamin B12 for proliferation during their differentiation.

Detailed explanation-2: -And given B12 is required for the production of red blood cells, a deficiency in Vitamin B12 can lead to a deficiency in Iron. This is why the onset of anemia is often the result of a B12 deficiency rather than an Iron deficiency on its own.

Detailed explanation-3: -Vitamin B12 and vitamin B9 help form red blood cells. Without enough vitamin B12 or vitamin B9, your body produces abnormal cells called megaloblasts. Megaloblasts don’t divide and reproduce like healthy cells, which means there are fewer red blood cells in your bone marrow.

Detailed explanation-4: -Deficiencies of vitamin B12 and folic acid are the leading causes of megaloblastic anemia. Folic acid is present in food such as green vegetables, fruits, meat, and liver.

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