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Haematology Week 1 2018/19 > 3: Anaemia and microcytic anaemia > Flashcards

3: Anaemia and microcytic anaemia Flashcards

1
Q

What does anaemia mean?

A

Without blood

> Reduced total red cell mass

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2
Q

What measurements are used to diagnose anaemia?

A

Haemoglobin concentration or Haematocrit

because you can’t actually measure red cell mass

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3
Q

What is haematocrit?

A

Volume of red blood cells / Blood volume

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4
Q

In what situations can anaemia be mistakenly diagnosed?

A

Rapid bleeding

Rapid plasma expansion (e.g fluids)

because the total blood volume changes, not the red cell volume

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5
Q

What happens to the rate of red blood cell production in anaemia?

A

Increases

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6
Q

What is an increase in immature red cell number called?

A

Reticulocytosis

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7
Q

What is an immature red blood cell called?

A

Reticulocyte

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8
Q

What process occurs in the bone marrow in anaemia?

A

Reticulocytosis

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9
Q

What tool is used to get a FBC, MCV, red/white cell number etc?

A

Automated cell counter

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10
Q

Reticulocytes still have residual RNA.

What colour does this RNA turn on a blood film?

A

“Polychromatic”

Blue-grey

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11
Q

What are three measurements given by an automated cell counter re: RBCs?

A

Haemoglobin concentration

Red cell count

Mean cell volume (MCV)

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12
Q

What are the two main causes of anaemia?

A

Increased RBC loss

Decreased RBC production

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13
Q

What should happen to cell size as progenitor red blood cells divide?

A

Cell size should decrease

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14
Q

Microcytic anaemia is caused by a problem with ___ synthesis.

A

haemoglobin synthesis

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15
Q

What size are red blood cells in anaemia caused by decreased haemoglobin synthesis?

A

Small

Microcytic anaemia

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16
Q

What is the most common cause of microcytic anaemia?

A

Iron deficiency

17
Q

Iron deficiency is the most common reason for microcytic anaemia.

What is a deficiency of globins called?

A

Thalassaemia

another common reason for microcytic anaemia

18
Q

Where is most body iron found?

A

RBCs

rest in macrophages, liver, bone marrow

19
Q

In what form is iron stored in the liver?

A

Ferritin

20
Q

Which transport protein takes iron from the blood to macrophages in the bone marrow?

A

Transferrin

21
Q

Which cells transfer iron to red blood cells in the bone marrow?

A

Bone marrow macrophages

22
Q

In what forms is iron

a) functioning in the body
b) transported in the circulation
c) stored in the liver?

A

a) Haemoglobin
b) Transferrin
c) Ferritin

23
Q

What two measurements show that a patient has iron deficiency?

A

Low storage ferritin

Low haemoglobin (functional iron)

24
Q

What are three causes of iron deficiency?

A

Inadequate iron intake

Malabsorption

Blood loss

25
Q

(Men / Women) are more likely to be iron deficient.

A

Women

Men tend to have greater iron intakes

26
Q

From which part of the GI tract is iron absorbed?

A

Proximal jejunum

27
Q

Which autoimmune condition affects the proximal jejunum and can therefore cause iron deficiency?

A

Coeliac disease

28
Q

What are some chronic causes of blood loss which might cause an iron deficiency?

A

GI - peptic ulcers, H pylori, insidious tumours

Gynae - menorrhagia

Renal - haematuria (AKI)

29
Q

What are some clinical signs of iron deficiency?

A

Koilonychia

Angular stomatitis

Glossitis

30
Q

Iron deficiency causes a (microcytic / macrocytic) anaemia.

A

microcytic

because the problem is with hb synthesis in the cytoplasm, not nucleus

31
Q

What is iron’s main transport protein?

A

Transferrin

32
Q

In which cells is haemoglobin synthesised?

A

Immature red blood cells

33
Q

To which part of immature red blood cells is iron transported for haemoglobin synthesis?

A

Mitochondrion

34
Q

Fe2+ + ___ => Haem

A

Fe<strong>2</strong>+ + Porphyrin ring => Haem

35
Q

Haem + ___ => Haemoglobin

A

Globins

36
Q

Where is

a) haem
b) haemoglobin

made?

A

a) Mitochondria of immature RBCs

b) Cytoplasm of immature RBCs

37
Q

What are the two most common causes of microcytic anaemia?

A

Iron deficiency

Thalassaemia

Haematology Week 1 2018/19 (9 decks)

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