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2=Haematology > 2. Anaemia > Flashcards

2. Anaemia Flashcards

1
Q

what gives Hb its red colour?

A

haem

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2
Q

2 components of Hb

A

globin + haem

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3
Q

how many polypeptide chains in Hb?

A

4

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4
Q

describe polypeptide composition of hb

A

2 x alpha
2 x beta
each chain has 1 iron chain

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5
Q

function of Hb

A

transport o2 from lungs to tissue

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6
Q

describe what happens to Fe when it releases oxygen

A

goes from Fe2+ to \fe3+

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7
Q

4 requirements for RBC to undergo gaseous exchange

A
  1. repeatedly pass through microcirculation
  2. come into close contact with tissues
  3. maintain Hb in reduced Fe2+ state
  4. maintain osmotic equilibrium
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8
Q

through which pathway do RBC generate ATP

A

embden-Meyerhof pathway

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9
Q

through which pathway do RBC generate reducing power as NADPH

A

hexose-monophosphate pathway

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10
Q

normal Hb range in males

A

130-170 g/l

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11
Q

normal Hb range in females

A

120-155 g/l

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12
Q

which protein transports Fe to develpoing RBC?

A

transferrin

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13
Q

how does Fe attach to the developing RBC?

A

transferrin receptors

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14
Q

iron is either stored as… (2)

A

haemosiderin or ferritin

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15
Q

what is 67% of iron stored as

A

ferritin

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16
Q

where is ferritin found

A

liver, BM, spleen, muscles

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17
Q

where is haemosiderin found

A

cells which do not ciruclate blood

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18
Q

average dietary intake of iron ?

A

10-15 mg

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19
Q

how much iron is absorbed through SI?

A

5-10%

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20
Q

which is more readily absorbed type of iron; animal or veg?

A

animal

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21
Q

where is iron lost?

A

menses, hair, nails, skin, urine, faeces

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22
Q

name 5 sources of dietary iron

A
  1. red meat - liver
  2. fish; salmon, tuna, sardines, pilchards
  3. veg and pulses
  4. cereal
  5. egg yolk
  6. wholemeal bread
  7. nuts and prunes
  8. marmite
  9. fortified foods
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23
Q

other name for vitamin B12

A

cobalamin

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24
Q

how is VB12 transported in the plasma?

A

bound to transcobalamin

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25
Q

why is VB12 bound to transcobalamin?

A

prevent acid degradation

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26
Q

VB12 acts as a coenzyme for which 2 biochemical reactions?

A
  1. methylation of homocystiene into methionine

2. methylmalomyl coenzyme A into succinyl CoA

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27
Q

what 2 processes is VB12 needed for?

A
  1. myelin production

2. DNA synthesis for RBC

28
Q

what occurs in DNA synthesis for RBC if VB12 is deficient?

A
  1. erythrocytes are in maturation arrest

2. no reticulocytes produced

29
Q

normal dietary intake of VB12

A

10-15 mcg

30
Q

where is VB12 stored

A

liver

31
Q

how much VB12 is stored in the liver

A

enough for 2-4 yrs

32
Q

where and how is VB12 absorbed?

A

it attaches to intrinsic factor (which is secreted by the stomach)

both are aborbed by ileum

33
Q

3 ways VB12 is lost

A

urine, faeces, bile

34
Q

name 5 sources of VB12

A
  1. liver
  2. heart
  3. clams
  4. oysters
  5. red meat
  6. eggs
  7. fortified foods
  8. milk
  9. cheese
  10. kidney
  11. seafood
  12. yoghurt
35
Q

other names for folic acid?

A

VB9, folate, pteroglutamic acid

36
Q

can humans synthesis VB9?

A

no

37
Q

what can VB9 be destroyed by?

A

heat

38
Q

where is VB9 absorbed?

A

jejunum

39
Q

which 3 small intestine diseases is VB9 common in/

A

chrons, coeliac, tropical sprue (malabsorption)

40
Q

how long do the bodys stores for VB9 last for?

A

3m

41
Q

2 MAIN roles of VB9

A
  1. biochemical reactions

2. production of new cells

42
Q

which 3 biochemical reactions if VB9 involved in?

A
  1. homocysteine into methionine
  2. serine into glycine
  3. synthesis of DNA precursors
43
Q

name 5 dietary sources of VB9

A
  1. liver
  2. leafy greens (spinach)
  3. turnip
  4. lettuce
  5. beans
  6. peas
  7. breakfast cereals
  8. fruit (banana, melon, lemon)
44
Q

name 6 tissue abnormalities associated with VB9/VB12

A
  1. cleft lip
  2. spina bifida
  3. sterility
  4. morphological abnormalities of cervix/bladder
  5. reversible melanin pigmentation
  6. CVD + malignant disease
45
Q

how is anaemia classified?

A

by the size of RBC (mean cell volume)

46
Q

3 classifications of anaemia

A
  1. normocytic
  2. microcytic
  3. macrocytic
47
Q

normal RBC size

A

78-100 f/l

48
Q

why is there anaemia with normal sized RBC (normocytic anameia)

A

issue is with the number of RBC

49
Q

name 4 causes of microcytic anaemias

A
  1. thalassaema
  2. iron deficiency
  3. other Hb defects
  4. anaemia of chronic disease
50
Q

name 2 subtypes of macrocytic A

A

megaloblastic + non-megaloblastic

51
Q

difference between megaloblastic + non-megaloblastic

A

megaloblastic - results from inhibition of DNA synthesis during RBC production
non - mB = no inhibition

52
Q

3 causes of megaloblastic macrocytic anaemias

A
  1. Vit B9 def
  2. Vit B12 def
  3. autoimmune (pernicious anaemia)
53
Q

2 causes of non-megaloblastic macrocytic anaemias

A
  1. myelodyplastic syndromes

2. liver disease

54
Q

3 causes of normocytic anaemia

A
  1. anaemia of chronic disease
  2. acute blood loss
  3. haemolytic anaemia
55
Q

what is haemolytic anaemia

A

increased rate of RBC destruction

56
Q

4 causes of anaemia of chronic disease

A
  1. cancer
  2. rheumatoid arthritis
  3. kidney disease
  4. drug treatment
57
Q

2 types of haemolytic normocytic A

A

hereditary/genetic or acquired

58
Q

2 causes of acquired haemolytic normocytic A

A

environmental or extracorpuscular

59
Q

4 environmental causes of acquired haemolytic normocytic A

A

drug induced, haemoglobinuria, malaria & E coli, heart value replacement

60
Q

3 extracorpuscular causes of acquired haemolytic normocytic A

A
  1. haemolytic disease of newborn
  2. autoimmune haemolytic A
  3. disseminated IV coagulation
61
Q

3 hereditary causes of normocytic haemolytic anaemia

A
  1. RBC membrane defects
  2. defective RBC metabolism
  3. disorder of Hb synthesis
62
Q

2 examples of RBC membrane defects

A
  1. spherocytosis

2. elliptoctosis

63
Q

2 examples of defective RBC metabolism diseases

A
  1. G6PD deficiency

2. pyruvate kinase deficiency

64
Q

2 disorders of Hb syntehsis

A
  1. sickle cell A

2. thalassaemia

65
Q

thalassaemia can be classified as 2 types f anemia; what are they?

A

microcytic and haemolytic normocytic

2=Haematology (9 decks)

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