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GIHEP > 26. GIT Anaemia > Flashcards

26. GIT Anaemia Flashcards

1
Q

Define anaemia in women

A

Hb < 11.5

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2
Q

Define anaemia in men

A

Hb <13

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3
Q

Where is iron absorbed from?

A

Stomach and duodenum

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4
Q

Where is folate absorbed from?

A

Duodenum to jejunum

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5
Q

Where is B12 absorbed from?

A

Terminal ileum

Must also have intrinsic factor from stomach

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6
Q

What are the causes of hypochromic microcytic anaemia?

A 
Iron deficiency
Chronic disease (usually normocytic)
Thalassaemia
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7
Q

What are the causes of iron deficiency anaemia?

A

Dietary
Loss
Malabsorption

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8
Q

What are the clinical features of iron deficiency anaemia?

A 
Mucosal pallor
Angular cheilitis
Atrophic glossitis
Brittle nails, koilonychia
Ice pica
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9
Q

What are the lab features of iron deficiency anaemia?

A 
Low Hb and ferritin
Low MCV
High total iron binding capacity
Reduced saturation of iron
Hyperplasia of bone marrow
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10
Q

What is the treatment for iron deficiency anaemia?

A

Iron replacement PO

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11
Q

What are the causes of B12 deficiency?

A

Lack intrinsic factor
Malabsorption
Increased use

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12
Q

What are the causes of a lack of intrinsic factor?

A

Pernicious anaemia
Atrophic gastritits
Partial gastrectomy

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13
Q

Give an example of how increased use causes a B12 deficiency

A

Blind loop bacteria syndrome

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14
Q

What are the lab features of B12 or folate deficient anaemia?

A

Low Hb
Increased MCV
Reduced serum folate or B12
Marrow hyperplasia

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15
Q

What are the clinical features of B12 deficiency?

A 
Peripheral neuropathy
Subacute combined degeneration of the cord
Optic atrophy
Psychiatric disorders
Atrophic glossitis
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16
Q

Why is folate given alongside B12 replacement?

A

Marrow will start rapidly making new RBCs so folate will be used up

17
Q

Give common causes of anaemia of chronic disease

A

IBD
RA, SLE, Sarcoid
Renal failure
Malignancy

18
Q

What is the pathophysiology of anaemia of chronic disease?

A

In pro-inflammatory states, the liver releases hepcidin

Causes a reduction in iron absorption and reduced release of iron from macrophages

19
Q

What are the causes of macrocytic anaemia?

A 
B12 and folate deficiency
Alcohol
Liver disease
Hypothyroidism
Reticulocytosis
20
Q

Why does liver disease result in macrocytic anaemia?

A

Liver makes lipids for RBC membrane

21
Q

What investigations can be done if a GIT cause of anaemia is suspected?

A 
Endoscopy and biopsies
Check for occult blood in stool
TGT antibodies in coeliac disease
Antibodies to parietal cells or intrinsic factor
Inflammatory markers

GIHEP (30 decks)

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