3. Anaemia Flashcards
Definition of anaemia
Reduction in Hb in the blood (not necessarily red cells)
Causes of anaemia (3)
Reduced production
Increased losses
Increased demand (pregnancy)
Reduced Hb production occurs because of (2)
Reduction in haem
Reduction in globin
Reasons for haem reduction (2)
Reduced number of normal cells (due to marrow failure) Deficiency states (iron, folate, B12)
Reasons for global reduction
Abnormal global chains (thalassemia, sickle cell, chronic inflammatory disease)
Definition and examples (3) of haematinics
Things used to make up RBCs
Iron
Vitamin B12
Folate
Diseases that reduce iron absorption (2)
Achlorhydria (lack of stomach acid, may be drug-induced, PPIs)
Coeliac disease
Causes of iron loss (4)
Gastric erosion and ulcers
IBDs
Bowel cancer
Haemorrhoids
Causes of vitamin B12 deficiency (3)
Lack of intake
Lack of intrinsic factor
Disease of terminal ileum (Crohn’s)
Causes of folate deficiency (2)
Lack of intake
Absorption failure
Complication of foetal folate deficiency
Spina bifida (open spinal defect/neural tube defect)
Definition of thalassemia
Normal haem production, genetic mutations of global chains
Types of thalassemia (2)
A-thalassemia
B-thalassemia
Clinical effects of thalassemia (5)
Chronic anaemia Marrow hyperplasia (skeletal deformities) Splenomegaly Cirrhosis Gall stones
Thalassemia management (2)
Blood transfusions
Prevention of iron overload
Definition of sickle cell anaemia
Abnormal global chains - change in shape of RBCs
Cause of shape change
Due to low Hb and O2 environments
Effects of sickle cell anaemia (2)
RBCs cannot pass through capillaries
Can lead to tissue ischaemia (pain, necrosis)
Anaemics can have (2)
Normal RBCs but heavier bleeding
Abnormal red cells (autoimmune, hereditary)
Types of anaemia (3)
Microcytic (RBCs too small)
Macrocytic (RBCs too large)
Normocytic (fewer RBCs)
Causes of microcytic anaemia (2)
Iron deficiency
Thalassemia
Causes of microcytic anaemia (2)
Vitamin B12 deficiency
Folate deficiency
Causes of normocytic anaemia (2)
Bleeding
Renal and chronic disease
Definition of reticulocytes
Immature (almost mature) RBCs
What should be measured to diagnose anaemia (4)
Measure Hb
Measure RCC
Measure HCT
Measure MCV
Clinical presentations of anaemia (2)
Pale mucosa
Smooth (iron/ferritin deficiency) or beefy (vitamin B12 deficiency) tongue
Signs of anaemia (3)
Pale
Tachycardia
Enlarged liver/spleen (rare)
Symptoms of anaemia (5)
Tired Weakness Dizziness SoB Palpitations
Anaemia investigation (5)
MH FBC FOB Endoscopy/colonoscopy Renal function Bone marrow examination
Anaemia treatment (3)
Replace haematinics
Transfusions (production failure)
EPO replacement (production failure)
Differences between bleeding and deficiency (3)
RCC - reduced number/different RBC structure
HCT - abnormal HCT
MCV - reduced mean cell volume
