Macrocytic Anemia: The Workup

Megaloblastic Anemia

The workup for macrocytic anemia should include some or all the following: Peripheral blood smear Hypersegmented neutrophils and macroovalocytes → B12 or folate deficiency. Pancytopenia → advanced B12 deficiency Target cells → chronic liver disease (anemia and thrombocytopenia are also seen). Pseudo-Pelger-Huët cells → myelodysplastic syndrome. For vitamin B12 deficiency Vitamin B12 levels Methylmalonic acid and … Read more

Myasthenia Gravis: The Workup

Myathenia Gravis

Here’s a workup for suspected myasthenia gravis: Acetylcholine receptor antibody Muscle specific receptor tyrosine kinase (MuSK) antibody Chest CT (to look for thymoma) TSH (concomitant autoimmune thyroiditis is sometimes seen) Search for underlying infectious precipitants as guided by history (e.g., CBC, chest radiograph, urinalysis) Search for underlying concomitant metabolic derangements which may contribute to weakness … Read more