1.3 Anaemia

Question 1

What type of haemoglobin do most of the population have?

Answer 1

HbA (>95%)

Question 2

What type of haemoglobin do those with sickle cell anaemia have?

Answer 2

> 90% have HbS

Question 3

Name 4 symptoms of anaemia

Answer 3

fatigue
breathlessness
palpitations
angina

Question 4

Name 5 clinical signs of anaemia

Answer 4

pallor
tachycardia
bounding pulse
flow murmur
signs of heart failure

Question 5

How might you assess pallor?

Answer 5

if the conjunctiva is pale

Question 6

Name 2 other signs of anaemia

Answer 6

Koilonychia

Angular stomatitis

Question 7

What are the 3 GENERAL causes of anaemia?

Answer 7

Reduced production
increased destruction
poor function

Question 8

How might iron deficiencies lead to anaemia?

Answer 8

they are essential for the production of haemoglobin

Question 9

Why might folate and B12 deficiency cause anaemia?

Answer 9

Folate is needed to turn uracil into thymidine, B12 is required for this.
This might occur in pernicious anaemia (AI), or any increased blood cell turnover, such as with a malignancy

Question 10

Name 3 bone marrow pathologies reducing production in RBC’s

Answer 10

Aplastic anaemia
myelodysplasia
myeloma

Question 11

What is aplastic anaemia?

Answer 11

the bone marrow simply doesn’t produce enough red blood cells

Question 12

What is myelodysplasia?

Answer 12

RBC progenitor differentiation blocker (type of cancer) in the bone marrow

Question 13

What is Myeloma?

Answer 13

cancer of the plasma, which can get into the bone marrow and disrupt RBC production

Question 14

Name 3 chronic diseases which might reduce production of RBC’s

Answer 14

renal failure
myeloma
chronic inflammatory conditions

Question 15

Name 3 ways in which RBC’s may be destroyed

Answer 15

large spleen
haemolysis (immune/non-immune)
bleeding

Question 16

Name 3 general ways in which RBC’s may not function properly

Answer 16

RBC membrane defect
Haemoglobin defect (haemoglobinopathy)
RBC enzyme defect

Question 17

Name the 2 types of RBC membrane defect

Answer 17

hereditary spherocytosis

hereditary elliptocytosis

Question 18

What is hereditary spherocytosis?

how is it treated?

Answer 18

autosomal dominant
most are fine, but get bad with other diseases

treated with folic acid, splenectomy, or maybe transfusion

Question 19

Name 2 types of haemoglobinopathy

Answer 19

sickle cell anaemia

thalassaemia

Question 20

How is sickle cell anaemia treated? (2)

Answer 20

exchange transfusion

hydroxycarbamide

Question 21

What is thalassaemia?

what sort of distribution does it have?

Answer 21

AR disease
defect in alpha or beta chain
number of genes missing dictates severity

silk road distribution

Question 22

Name 2 types of RBC enzyme deficiency

Answer 22

G6PD deficiency

pyruvate kinase deficiency

Question 23

Who suffers from G6PD deficiency?

Answer 23

boys, as it’s X-linked

Question 24

What 2 values are important for anaemia diagnoses and cause investigations?

Answer 24

Hb

MCV (mean cell volume)

Question 25

What might be the cause of a low Hb and low MCV?

Answer 25

iron deficiency
thalassaemia
sickle cell disease

Question 26

What might be the cause of a low Hb but high MCV?

Answer 26

B12 and folate deficiency
alcohol
haemolytic anaemia

Question 27

What might be the cause of a Low Hb but normal MCV?

Answer 27

chronic disease
acute blood loss
bone marrow failure