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CR2 > 13 - Anaemia 1 > Flashcards

13 - Anaemia 1 Flashcards

1
Q

How many RBC are there

A

24 x10^12 trillion RBC - 1/3 total body cells

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2
Q

How much iron should the diet contain

A

15mg iron/day

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3
Q

What is the total body iron

A

3-5g

1mg absorbed and 1 mg excreted in urine/faeces, hair so balance, 2g iron is in the form of circulating Haemoglobin

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4
Q

Where is the majority of the iron absorbed in

A

duodenum by enterocytes

Iron only taken up as Fe++

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5
Q

What enzyme reduces Fe3+ to Fe2+

A

Ferric reductase

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6
Q

What is transferrin

A

Iron binding blood plasma glycoproteins

Takes iron from inside the enterocyte into the blood to the bone marrow

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7
Q

What does transferrin carry iron as

A

The ferric form FE3+

it can carry 2 irons

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8
Q

What takes up iron

A

Ferritin

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9
Q

What does levels of transferrin tell you

A

The ability of the blood to transfer iron from enterocytes

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10
Q

Ferritin

A

The iron is stored here

= it can release iron in a controlled manner

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11
Q

Where is ferritin found

A

In most tissues

and small amounts in the plasma as a carrier

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12
Q

What does plasma ferritin indicate

A

Indirect marker of the total amount of iron in the body

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13
Q

What does serum ferritin indicate

A

used as a diagnostic test for iron deficiency anaemia

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14
Q

What do you do if the Hb is low

A 
History and examination
Full blood count and blood film 
Serum B12, folate and ferritin
Test renal and liver function 
ESR - check if infection
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15
Q

What are further tests you can do

A

Hb electrophoresis

Bone marrow biopsy

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16
Q

What is anaemia

A

Low Hb level

Not a diagnosis

17
Q

What are the levels of hb for an adult male and female

A

<13.5 g/dl - male

<11.5 g/dl (female)

18
Q

What are the levels of hb for a human of age 6months - 6 y/o

A

<11 g/dl

19
Q

What are the levels of hb for a human of age 6 y/o to 14 y/o

A

<12 g/dl

20
Q

What are symptoms of anaemia

A

Tiredness
Fainting
SOB
palpitations

21
Q

What are signs of anaemia

A

Pallor
Rapid heartbeat
Bounding pulse
Systolic flow murmur

22
Q

What are causes of anaemia

A

Decrease in RBC production due to iron, folate, b12 deficiencies, infections, chronic disease
Increased destruction of RBC - haemolytic anaemia
Increase loss of RBC - bleeding

23
Q

What is microcytic anaemia

A

<76fl
Iron deficiency
Thalassaemia

24
Q

What is normocytic anaemia

A

76 - 96fl
Recent bleed
Chronic disease
Haemolytic anaemia

25
Q

What is macrocytic anaemia

A

> 96fl
B12 or folate def
Alcohol/liver disease

26
Q

What are 2 signs of iron deficiency anaemia on a blood film

A

Microcytic

hypochromatic (reduced hb)

27
Q

Why can you get iron deficiency anaemia

A

Low iron in diet
Reduced RBC synthesis
Excess iron loss

28
Q

What factors increase iron absorption

A 
Haem irons
ferrous salts (Fe2+)
Acid ph
Pregnancy 
Hypoxia
29
Q

What factors impair iron absorption

A 
Non-haem iron (veg) 
Ferric salts (Fe3+)
Alkaline PH
Iron overload 
Inflammatory disorders
Proton pump inhibitor
30
Q

What are some risk factors for anaemia

A 
Sex (Females>Males)
Appetite changes
Drugs - Aspirin, NSAID
Diet - Vegans, elderly 
Physiological - Pregnancy, adolescence
31
Q

How would you confirm iron deficiency anaemia

A

1) Blood count = Low RBC number
2) Blood film = Microcytic, hypochromatic
3) Serum ferritin - Low
4) Serum iron total binding capacity - Low

32
Q

What is the treatment for iron deficiency anaemia

A

Replace the iron
Improve the diet
Use iron tablets (ferrous sulphate)

33
Q

How long do you continue iron supplements once the Hb is normal

A

3 months

34
Q

What are causes of normocytic anaemia

A

Acute blood loss
Chronic disease
Cancer
Haemolysis

35
Q

Why does chronic disease cause normocytic anaemia

A

Inflammation - reduces RBC lifespan - depressed erythropoiesis - poor marrow response to EPO (inflammatory cytokines interfere with EPO production/action)

CR2 (34 decks)

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