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MedEd Tutorials > 22. Anaemia > Flashcards

22. Anaemia Flashcards

1
Q

Signs of anaemia?

A

Pallor
Fatigue
Increased RR and HR

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2
Q

What might cause iron deficiency anaemia?

A

A microcytic

Malnutrition
Coeliacs
IBD

GI malignancy (if IDA, change in bowel habit and PR bleeding, it’s colon cancer)
Peptic ulcer
Menstruation

Pregnancy
Fever

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3
Q

What is anaemia of chronic disease?

A

Chronic disease produces cytokines that increase hepcidin.

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4
Q

Difference between IDA and ACD?

A

Ferritin is low in IDA but is high or normal in ACD.

Total iron binding capacity is high in IDA and low in ACD, ACD can often be normocytic too.

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5
Q

What is thalassaemia?

A

Autosomal recessive condition which can affect the alpha or beta chains.

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6
Q

How do we investigate thalassaemia?

A

Microcytic anaemia
Normal iron studies
Gel electrophoresis

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7
Q

How do we treat thalassaemia?

A

Regular red cell transfusions every 2-4 weeks with iron chelation

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8
Q

When do you produce your chains of globin?

A

Alpha is before birth
Beta is from early infancy
Gamma is present before birth but drops after born.

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9
Q

What is sickle cell disease?

A

Mutation on chromosome 11.

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10
Q

How does sickle cell present?

A

Often asymptomatic
Hypoxia
Dehydration
Pain in joints

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11
Q

What is a howell-jolly body?

A

Abnormal cell formed from left over DNA

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12
Q

What are the 5 main cornerstones of a sickle cell crisis?

A 
Crisis
Acute painful crisis
Stroke
Sequestration crisis
Chronic cholecysitits
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13
Q

Managing a sickle cell crisis?

A

Sickle Acute Painful Crisis

Saturate (oxygen)
Antibiotics
Pain relief
Cannula (fluids)
Crizanlizumab

Blood transfusion, splenectomy and cholecystectomy

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14
Q

How do we diagnose sickle cell?

A

Hb electrophoresis and blood film

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15
Q

MOREHow do we manage day-to-day sickle cell anaemia?

A

/

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16
Q

What causes megaloblastic anaemia and what do you see?

A

Folate or B12 deficiency

Hypersegmented neutrophils and macrocytes

17
Q

How do differentiate between B12 and folate deficiency?

A

B12 - alcohol, IBD and coeliac, neurological signs, pernicious (stores last 3-4 years)

Folate - pregnancy, no neuro signs, anti-folate drugs (stores last 6 months)

18
Q

What causes non-megaloblastic macrocytic?

A

Alcoholics May Have Life Failure

Alcohol
Myelodysplasia
Hypothyroidism
Liver failure

19
Q

What do you see in haemolytic anaemia?

A 
Scleral icterus
Pallor
Low Hb
Low haptoglobin
Raised unconj bilirubin
High LDH
20
Q

4 types of haemolytic anaemias?

A

Membrane - hereditary spherocytosis
Enzymes - G-6PD
Haemoglobin - sickle and thalassaemia

21
Q

What is characteristic of G-6PD?

A

Bite cells

Heinz bodies

22
Q

What is hereditary spherocytosis?

A

Lacking the centre of pallor, where you lack beta spectrin

23
Q

How would you investigate hereditary spherocytosis?

A

Osmotic fragility test causes lysis
Negative coombs test
Aplastic crisis - when body doesn’t produce enough haemoglobin

24
Q

What is microangiopathic haemolytic anaemia? (MAHA)

A

Shearing of red blood cells when microthrombi form which create nets that shear the cells.

25
Q

What is haemolytic uraemic syndrome? (HUS)

A

MAHA
AKI
Thrombocytopenia

In early childhood.

Associated with schistocytes and stomach bug (ecoli, shiga toxin)

26
Q

What is TTP?

A

Thrombotic thrombocytopenia purpura, where the enzyme that breaks down net in blood vessels is defunct

27
Q

How does TTP present?

A 
Decreased platelets 
AKI
MAHA
Temperature
Swinging CNS signs
Antiglobin negative
28
Q

What are some other haemolytic anaemias?

A

Autoimmune
Drugs - dapsone
Infection e.g. plasmodium

29
Q

What is myelofibrosis?

A 
Fibrosis in response to a BM malignancy
>65 years old
Radiation caused
Dry tap on biopsy 
CELL TYPE CHECK SLIDES

MedEd Tutorials (32 decks)

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