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YEAR 3 Manchester Medicine > 11 - Anaemia > Flashcards

11 - Anaemia Flashcards

1
Q

What does haematocrit show?

A

(RBC x MCV) / total blood volume

increase = polycythemia

decreased = aneamia

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2
Q

General signs of anaemia?

A

fatigue

weakness

pale/ yellow

irregular heart beats

SoB

Dizziness or light headedness

Chest pain

Cold hands and feet

headache

kolionychia - rare

Pica - craving for non food items

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3
Q

What does MCV indicate?

A

Type of aneamia

increased - macrocytic

normal - normocytic

decreased - microcytic

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4
Q

Causes of hypochromic microcytic aneamias?

A

Iron deficiency

Thalassaemias

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5
Q

What is the cause if iron dificiency aneamia?

A

Diet - vegan

Malabsorption - IBD, milk, tea

Blood loss from chronic disease

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6
Q

When to refer for endoscopic investigation with iron deficiency anaemia under the 2 week wait?

A

Dypsepsia

Unexplained

Women not menstruating

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7
Q

What is the most common cause of iron deficiency anaemia in children?

A

Due to Cows milk

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8
Q

Why might ferratin be derranged without pathology?

A

Rapid growth in infants and adolescents

inflammation - ferratin is an acute reaction protein

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9
Q

Iron deficiency specific signs of aneamia?

A

Headache during activity

Pica - wallpaper

sore tooth or tongue

Brittle nails and hair loss

koilonychia

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10
Q

Types of thalassaemia?

A

Alpha - controlled by 4 genes
Beta - controlled by 2 genes

Note: has aneamia, suffers from iron overload

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11
Q

What is beta thalassaemia major?

A

No HbB only HbF (fetal)

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12
Q

What are the causes of marcrocytic anaemia?

A

Alcohol

B12 deficiency

Folate deficiency

Malignancies

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13
Q

Causes of vit. B12 deficiency anaemia?

A

Nutrition - vegan, poor diet, pregnancy

Malabsorption

Crohns

IBD

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14
Q

What is perniscous anaemia?

A

Antibodies to parietal cells and intrinsic factor leading to B12 deficiency anaemia

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15
Q

What features are specific for B12 deficiency anaemia?

A

insidious onsel

jaundice

glossitis

angular stomatitis

neuropahy - peripheral, optical and dementia

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16
Q

What drugs can cause B12 deficiency anaemia?

A

Methotrexate

Anticonvulsants

Sodium valporate

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17
Q

Milk from what animal can cause B12 deficiency?

A

Goats - unlike cows has iron

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18
Q

What other causes of macrocytic aneamia other than megaloblastic?

A

Pregnancy

Chemotherpay

Hypothyroidism

Liver disease

Hypoxia

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19
Q

What types of heamolytic anaemias?

A

Congenital

Aquired

20
Q

What is the most common inhertied RBC disorder in northern europeans?

A

Heredity spherocytosis

21
Q

How is hereditary sphenocytosis diagnosed?

A

Posotive family history and surgestive finding on blood film

Can use EMA binding test resulting in weaker flourescence

22
Q

What is sickle cell aneamia?

A

Co-dominant ß thalassaemia

Results in loss of concave RBC to sickle cell

23
Q

What complication can occur in sickle cell thalassaemia?

A

Autospleen infactation

Crisis Types:

Painful

Chest

Abdomen

Stroke

24
Q

Management of sickle cell crisis?

A

Analgesia - IV opiates

Crossmatch blood

Rehydrate

Keep warm

Transfussion if decrease of RBC

25
Q

Recommendation to patient with sickle cell anaemia

A

Keep warm

Keep hydrated

Keep regular hours

Eat well

Prophylaxis penecillin - spleen

Hydroxyurea/ hydroxycarbamide

26
Q

What does hydroxyurea/ hydroxycarbamide do?

A

incraeses fetal heamoglobin production therefore reducing the reliance on HbSS

27
Q

What is sickle cell protective against?

A

Malaria - parasite is not viable inside the sickle cell RBC

28
Q

Gucose-6-phosphate dehydrogenase deficiency

A

X linked

Mediterianian, africa, middle east

Attacks - fratigue, nack ache, jaundice and dark coloured urine

Presipitated by henna, premaquine, asprin

29
Q

What is coombs test?

A

Antihuman Antibodies introduced to blood sample,

If agglutination occurs then +ve result

+ = most aquired heamolytic conditions

30
Q

How is stroke risk managed in sickle cell disease?

A

Trancranial doppler indicates blood flow in circle of willis

MRI reveals strokes

= stem cell therapy or blood transfussion

31
Q

How is Iron regulated?

A

Low transferretin saturation (indicates low iron) –> decreases hepicidin activity –> increases feroportin

=> release of iron from enterocytes and marrow marcrophages

Therefore increasing Iron levels

32
Q

Treatment of heredity spherocytosis?

A

B12 suppliment

may need splenectomy

33
Q

Recomendation to a patient taking iron tablets?

A

Take on empty stomach

Don’t take with tea, cofee and milk

34
Q

What are the side effects of taking iron suplimment tablets?

A

GI problems

Constipation

Diarrhoea

Stools may turn balck!

35
Q

What drugs can effect iron uptake with supplment tablets?

A

TCA reduce Fe uptake

Ca products

Levothyroxine uptake is reduced with Fe suppliment

36
Q

How is B12 suppliment given?

A

IV hydroxycoalbumin

repeat every 2-3 months

37
Q

When would you also use Folic aciud supplement?

A

When folate defiency is proven otherwise may exacerbate B12 deficiency.

Usually given with B12 vit

38
Q

What is a frequent complication of Hereditary Spherocytosis?

A

Gall stones

39
Q

A female of 26 has hypochromic microcytic anaemia. What is the most likely cause? What additional investigations should be done?

A

Anaemia due to menorrhagia.

vWD should be considered

40
Q

How is beta thallasaemia trait diagnosed?

A

increased HbA2 (adult variant haemoglobin)

41
Q

How many genes are involved in Alpha thalasaemia?

A

2 for each of HbA and HbA2

42
Q

Is thalassaemia major present at birth?

A

No due to HbF, presents 6 months after birth

43
Q

Which thalasaemia presents with hydrops fetalis?

A

Alpha not Beta, iron-deficiency anaemia can also cause hydrops fetalis

44
Q

What is hydrops fetalis?

A

2 or more compartments have oedema. Caused from heart failure due to increased blood flow to deliver oygen to tissue.

45
Q

What is fetal Rh incompatibilty?

A

Where the mother is Rh -ve and the fetus is Rh + and the mother’s immune system causes heamolysis of HbF. Mother has to be previously sensatised by previous Rh+ pregnancy.

46
Q

What does this head X ray indicate?

A

Thalasaemia major

Sickle cell aneamia

Heredity spherocytosis

Iron deficiency anaemia

47
Q
A

YEAR 3 Manchester Medicine (34 decks)

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