Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medical Studies 1 > 10.6 Anaemia Part 2 > Flashcards

10.6 Anaemia Part 2 Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

MCV (Mean cell volume) in micro/normo/macrocytic anemia:

A

Micro: <80fL
Normo: 100fL
Macro: >100fL

fL = femtolitres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

TAILS acronym for causes of microcytic anaemia:

A
  • Thalassaemia
  • Anaemia of chronic disease
  • Iron deficiency
  • Lead poisoning
  • Sideroblastic anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List some causes of normocytic anaemia

A
  • Anaemia of chronic disease
  • Haemolysis
  • Mixed B12/folate/iron deficiency
  • After acute blood loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a megaloblast. What causes their appearance?

A

Large, nucleated, erythroblast; delayed maturation of nucleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Megaloblastic vs non-megaloblastic macrocytic anaemia

A

Refers to presence/absence of megaloblasts in bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List some causes of macrocytic anaemia

A
  • B12/folate deficiency
  • Alcohol excess
  • Liver disease
  • Haemolysis (With reticulocytosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the role of folate in DNA synthesis?

A

Produces purines (adenine and guanine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where is vitamin B12 absorbed, and what is it bound to (+where is that made?)

A
  • Absorbed in ileum
  • Must be bound to intrinsic factor
  • IF is made in parietal cells of stomach
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where is folate absorbed?

A

Duodenum and jejunum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

True or false: folate plays a role in DNA synthesis during purine production, but B12 has no role in DNA synthesis

A
  • False
  • Both are involved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Can we make vitamin B12 within our microbiomes?

A
  • No
  • We get if from animals, who obtain it from:
    1. Eating bacteria-contaminated food
    2. internal production
    3. Eating food of animal origin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Are there any vegan/vego food sources of B12?

A

Nope. None.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

List some dietary sources of folate

A
  • Liver
  • Leafy greens
  • Yeast
  • Breads and cereals (fortified)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Can folate withstand cooking well?

A

No. It is easily destroyed by this.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Nutritional cause of B12 deficiency

A

Veganism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nutritional causes of folate deficiency

A
  • Old age
  • Institutions
  • Poverty
  • Famine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

List some causes of malabsorption which can cause vitamin B12 deficiency

A
  • Pernicious anaemia (no IF)
  • Ileal resection
  • Crohn’s disease
  • gastrectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

List one way in which malabsorption can cause folate deficiency

A

Coeliac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

List some conditions under which the body’s folate usage increases

A
  • Pregnancy
  • Haemolytics anaemia
  • Cancer
  • Inflammatory diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

List one type of drug that can cause folate deficiency

A

Anticonvulsants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the mechanism behind pernicious anaemia?

A
  • Autoantibody response attacks stomach
  • Leads do destruction of gastric mucosa -> parietal cells destroyed
  • Cannot secrete intrinsic factor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

List some clinical features of megaloblastic anaemia

A
  • Glossitis
  • Angular stomatitis
  • Malabosorption symptoms (e.g. weight loss)
  • Neuropathy
  • Neural tube defect (in pregnant women)
23
Q

List some broad features of haemolysis of RBCs

A
  • Increased RBC breakdown
  • Increased RBC production to compensate
  • Damaged red cell on films
24
Q

Why can haemolytic anaemia cause macrocytosis? Under what circumstances could it be normocytic?

A
  • In response to RBC haemolysis, the body produces more erythrocytes
  • This leads to reticulocytosis
  • Since reticulocytes are larger than erythrocytes, this increases MCV
  • If there is not an adequate marrow response, then we see normocytic anaemia, as no reticulocytes are produced
25
Q

Explain intrinsic vs extrinsic haemolytic anaemia

A

Intrinsic: RBCs are destroyed because they are defective
Extrinsic: Destroyed by factors outside the cell itself

26
Q

List some causes of intrinsic haemolytic anaemia

A
  • Membrane defects
  • Metabolic defects (e.g. G6PD)
  • Haemoglobin defects (HbS)
27
Q

List some causes of extrinsic haemolytic anaemia

A

-Autoimmune/alloimmune (e.g. transfusion) conditions
- Red cell fragmentation syndromes
- Infections
- Burns

28
Q

Briefly describe glucose 6 phosphate dehydrogenase deficiency and its role in in intrinsic haemolytic anaema

A
  • G6PD is an enzyme required to produce a compound that protects your RBCs from oxidative stress. Therefore, if you don’t have eough, your cells are vulnerable.
  • You can get bouts of acute haemolytic anaema when the stress increases, such as in stress or eating fava beans.
  • More common in men (favas)
29
Q

Which gene is mutated in HbS

A

Beta-globin gene on Chromosome 11 (same as beta thalassaemia)

30
Q

Does HbS have a lower or higher O2 affinity than HbA?

A

Lower affinity; lets go more easily

31
Q

How would we treat a patient who is struggling with an acute issue relating to HbS?

A
  • Supportive care (treat symptom)
  • Folic acid
  • Exchange transfuion
  • Stem cell transplantation
32
Q

Intravascular vs extravascular haemolytic anaemia

A

Intra: within vessels
Extra: outside of vessels, such as in the spleen or liver

33
Q

Describe the two different kinds of autoimmune haemolytic anaemia. What antibody class is involved in each?

A
  • Warm: 37°C (IgG)
  • Cold: 4°C (IgM)
34
Q

List the three kinds of immune-mediated haemolysis

A
  • Autonimmune haemolytic anaemia
  • Alloimmune
  • Drug-induced
35
Q

True or false: alcohol and liver disease can cause macrocytic anaemia

A

True

36
Q

Does anaemia always have severe symptoms in well-established cases?

A
  • No
  • If the onset was slow enough, patients may not notice
37
Q

List some general symptoms and signs of anaemia

A
  • Fatigue
  • Dyspnoea
  • Weakness
  • Lethargy
  • Palpitations
  • Cardiac failure
  • Pallor mucous membranes
38
Q

What type of anaemia is indicated by koilinychia

A

Iron deficiency

39
Q

What type of anaemia is indicated by jaundice, neuropathy, and angular stomatitis

A

B12/folate deficiency

40
Q

What type of anaemia is indicated by petechiae and splenomegaly?

A

Marrow disorders (too many dodgy cells, spleen enlarges to kill them)

41
Q

List four investigations for anaemia

A
  • Iron studies
  • B12/folate
  • markers of haemolysis
  • Haemoglobin electrophoresis
42
Q

What are some indicators of haemolysis?

A
  • LDH
  • Bilirubin
  • Reticulocyte count
43
Q

Think of twso haemoglobinopathies than can be detected with Hb electrophoresis

A
  • Sickle cell disease
  • Thalassaemia
44
Q

Is iron deficiency a diagnosis?

A
  • No
  • Seek the underlying cause; always consider blood loss
45
Q

Where is most of the iron stored in the body?

A
  • Liver
  • Spleen
  • Bone marrow
46
Q

Identify vulnerable demographics for iron deficiency

A
  • Women (menstruation)
  • Pregnant women
  • Vegetarians/vegans
  • Elderly
  • Children
47
Q

List some iron-rich foods

A
  • Red meats, fish, poultry, eggs
  • Legumes
  • Grain products (whole-grain)
  • Dark, leafy greens and dried fruits
48
Q

What is the efficiency of iron intake?

A

14% (7mg in per 1mg absorbed)

49
Q

Can the body excrete iron?

A

No

50
Q

Is divalent or trivalent iron more easily absorbed into the bloodstream?

A

Divalent; this is why meat iron is easier to absorb than veggie iron

51
Q

What factors can increase iron absorption?

A
  • Stomach Acid
  • Heme form
  • High RBC demand
  • Meat Factor Protein (MFP)
52
Q

What factors can decrease iron absorption (with a dietary focus)?

A
  • Low stomach acid (antacid use)
  • Dietary fibre (binds to iron)
  • Oaxilic acid
  • Polyphenols/tannins in tea/coffee
  • Excess minerals
53
Q

What factors can increase the absorption of non-haem iron? How does this give rise to food pairing?

A
  • Meat Factor Protein and vitamin C
  • Therefore, pairing plant iron with foods that contain these can maximise absorption
54
Q
A

Medical Studies 1 (90 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions