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231 Anaemia Flashcards

1
Q

What are the progenitor cells of RBCs?

A

BFU-GEMM (burst forming units) Granulocute Erythrocyte Monocyte Megakaryocyte

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2
Q

Which RBC progenitor contains: - basophilic cytoplasm - lots of organelles - no Hb - sparse chromatin

A

Pronormoblasts

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3
Q

Which RBC precursor synthesises 20-30% of total Hb?

A

reticulocytes

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4
Q

Where is the majority of EPO synthesised?

A

Peritubular cells of the kidney

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5
Q

Where is 10% of EPO synthesised?

A

Kupffer cells and hepatocytes in the liver

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6
Q

What is the major stimulus for EPO release?

A

Hypoxia

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7
Q

Name 2 conditions where recombinant EPO is used as treatment (4 listed)

A
  1. Anaemia due to renal failure 2. Autologous blood transfusion 3. Post chemo/bone marrow transplantation 4. Myeloblastic syndromes
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8
Q

Which vitamin aids ferric iron absorption?

A

Vit C

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9
Q

Where is Fe3+ converted into Fe2+?

A

Stomach

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10
Q

Where in the GIT is Fe2+ absorbed?

A

Duodenum and jej

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11
Q

Fe2+ + apoferritin = ?

A

Ferritin

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12
Q

What is ferritin?

A

Intracellular protein which stores iron

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13
Q

What is transferrin?

A

Protein in the blood which binds to and transports iron around the body

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14
Q

What is hepcidin?

A

Peptide hormone synthesised in the liver and regulates iron metabolism and absorption

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15
Q

What are Vit B12 and folate important for?

A

DNA synthesis and mitosis

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16
Q

What type of anaemia is seen in a patient with folate and VitB12 deficiency?

A

Megaloblastic

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17
Q

What is the mechanism of pernicious anaemia?

A

IgG autoantibodies against parietal cells in the stomach which also make IF. IF important for absorption of VitB12 in distal ileum –>B12 deficiency and anaemia

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18
Q

What is the most common cause of iron deficiency anaemia in women of child bearing age?

A

Menstruation

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19
Q

What is the most common cause of iron deficiency anaemia in post menopausal women?

A

GIT bleeds

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20
Q

What are the general causes of iron deficiency anaemia?

A
  1. reduced iron intake
  2. reduced iron absorption
  3. increased requirement for iron
  4. chronic blood loss
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21
Q

What is the morphology RBCs in iron deficiency anaemia?

A

Microcytic hypochromic

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22
Q

What are the FBC features of iron deficiency anaemia?

A
  • ↓ iron
  • ↓ ferritin
  • ↑ transferritin
  • ↑ TIBC
  • ↓ plasma transferrin saturation
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23
Q

Name 2 specific features of iron deficiency anaemia

(5 listed)

A
  1. Glossitis
  2. Koilonychia
  3. Angular stomatitis
  4. Alopecia
  5. Pica
24
Q

What is the mechanism behind anaemia of chronic disease?

A

Anaemia due to activation of cellular immunity and production of pro-inflammatory cytokines which decreases erythrocpoiesis

25
What is the morphology of RBCs in anaemia of chronic disease?
Normocytic/microcytic and normochromic
26
What is the treatment of iron deficiency anaemia?
Ferrous sulphate tablets
27
Name 3 features of haemolytic anaemia | (6 listed)
1. pallor 2. jaundice (increased unconjugated BR) 3. Dark urine (increased urobilinogen) 4. Pigment gallstones 5. Splenomegaly 6. Reticulocytosis (increased MCV)
28
What is the reason for bone deformities in haemolytic anaemia?
Eythroid hyperplasia
29
Name 3 causes of haemoltic anaema | (6 listed)
1. hereditdary spherocytosis 2. pyruvate kinase deficiency 3. G6PD 4. drug induced 5. mechanical 6. Microangiopathic haemolytic anaemia
30
What is hereditary spherocytosis?
Autosomal dominant condition where there's a defect in spectrin (cytoskeletal protein) which causes loss of the membrane spherocytosis and haemolysis
31
What is the mechanism of haemolytic anaemia in G6PD deficiency?
X linked condition which affects glucose 6 phosphate dehydrogenase in the hexose monophosphate shunt normally responsible for excreting waste in the RBC
32
What is the mechanism of haemolytic anaemia in pyruvate kinase deficiency?
AR disorder which affects the glycolytic pathway meaning decrease of ATP and RBCs become rigid and get destroyed
33
Which drugs can induce haemolytic anaemia?
Penicillin, cephalosporins, flu-darabine
34
Which metel can cause haemolytic anaemia?
Lead poisoning
35
What is microangiopathic haemolytic anaemia?
Fibrin is deposited in the small vessels causing haemolysis
36
What is the morphology of RBCs in þ-thalassaemia?
Microcytic hypochromic with reticulocytosis
37
What does HbH disease cause?
Chronic haemolysis
38
What is the cause of hydrops fetalis?
No alpha globulin genes and foetus dies un utero
39
Why is there hyposplenism in sickle cell disease?
Infarctions of splenic vessels
40
Name 2 causes of microcytic, hypochromic anaemia (3 listed)
* Iron deficiency * Thalassaemia * Sideroblastic
41
Name 2 causes of normocytic, normochromic anaemia (3 listed)
* Haemolysis * Chronic disease * Marrow infiltration * Iron deficiency WITH b12 deficiency
42
Which measurement of the FBC is raised in iron deficiency and B12 deficiency?
RDW - red cell distribution width
43
Name 2 causes of target cells | (3 listed)
* Obstructive jaundice * Thalassaemia * Sickle cell
44
What type of cells can be seen due to oxidant damage in e.g. G6PD deficiency?
Basket/blister cells
45
Which membrane protein is defective and can cause elliptocytosis in haemolytic anaemias?
Spectrin
46
Name 2 conditions where you would see fragments on a blood film? (5 listed)
* DIC * TTP * Burns * Cardiac valves * Microangiopathy
47
In which condition would you see pencil cells on a blood film?
Iron deficiency
48
What are prickle cells?
RBCs seen on blood film post splenectomy characteristic of pyruvate kinase deficiency
49
Would there be a right or left shift in the oxygen dissociation curve during alkalosis?
Left shift
50
What can cause a right shift in the oxygen dissociation curve?
* increased conc of 2,3 DPG * Acidosis * Increased CO2
51
On which chromosome is the beta globulin gene on?
11
52
On which chromosome are the alpha globulin genes on?
Chromosome 16
53
What is hydroxocobalamin?
B12 injections
54
What are desferoxiamine and deferasirox?
Iron chelators
55
What are venofer and cosmofer?
Perenteral iron

JG Year 2 (28 decks)

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