5.7 Anaemia Due to Malabsorption and/or GI Bleeding Flashcards
Give on example of a NON GI cause of anaemia from acute blood loss
Retroperitoneal haematoma
Anaemia from acute blood loss is _______cytic, because…
- Normocytic
- This is because new cells are not yet being made; no reason for macrocytic yet
In upper GI blood loss, we often see raised ____ due to…
- Raised urea
- Digestion of blood leads to protein breakdown products, leads to higher urea
Iron deficiency anemia is _____cytic and _____chromic, and can be caused by…
- Microcytic, hypochromic
- Can be caused by inadequate intake, absorption, increased demand, increased loss
Where is iron absorbed in the gut? List two causes of inadequate iron absorption?
- Absorbed in duodenum and proximal jejunum
- Inadequate absorption can be caused by duodenal disease (e.g. coeliac), and duodenal bypass (e.g. gastric bypass)
What is a gastric erosion?
Superficial muscosal defect; does not affect submucosa (this is an ulcer), just mucosa
The primary bacteria of concern for gastric erosion is…
Another interesting one is…
- Helicobacter pylori
- Another is mycobacterium tuberculosis
How, specifically, do NSAIDs casue gastric erosion?
- Topical irritant effect on mucosa; impaired barrier
- Reduced blood flow
- Impaired healing
(acidic stomach environment also impairs healing)
Specifically:
- Cox-1 inhibition leads to decrease prostaglanding
- Decreases protective effect of prostaglandin on gastric mucosa
- Increased susceptibility to mucosal injury
How is gastric erosion treated?
- Stop root cause (to stop erosion)
- Acid-suppressive treatment (to promote healing)
What kinds of medications/endoscopic procedures/surgical procedures are used to treat GI bleeding?
- Medications: pro coagulants, PPIs
- Endoscopic: thermal therapy (vasoconstriction, coagulation, edema)
- Surgical: bypass, suturing, ligatures
