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haem am > Acquired anaemia > Flashcards

Acquired anaemia Flashcards

1
Q

What are the 3 types of anaemia?

A

Hypochronic mycrocytic
Normochronic normocytic
MAcrocytic

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2
Q

What investigations are done to determine what kind of anaemia?

A

FBC- Hb and MCV

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3
Q

What investigation is used in hypo chromic microcytic anaemia?

A

Serum ferritin

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4
Q

What would a low serum ferritin in hypochromic microcytic signify?

A

Iron deficiency anaemia- most common type

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5
Q

What are causes of iron deficiency anaemia?

A

Bleeding= most common- GI, menorrhagia
Diet- malabsorption
Increased requirement- pregnancy

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6
Q

What is the management of iron deficiency anaemia?

A

Treat cause
Oral iron- IV if intolerant
Rare= blood transfusion

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7
Q

What would cause hypo chromic microcytic with a normal/high serum ferritin?

A

Thalassaemia

Anaemia of chronic disease

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8
Q

What investigation is used to differentiate normochromic normocytic anaemia?

A

Reticulocyte count

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9
Q

What would a high reticulocyte count in normochromic normocytic anaemia signify?

A

Acute blood loss

Haemolysis

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10
Q

What would a normal/low reticulocyte count in normochromic normocytic anaemia signify?

A

Anaemia of chronic disease

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11
Q

Why are reticulocytes elevated in haemolytic anaemia?

A

Accelerted RBC destruction compensated by bone marrow

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12
Q

What are the causes of haemolytic anaemia?

A

Congenital- G6PD, sickle cell, thalassaemia, spherocytosis

Acquired- autoimmune, transfusion reaction, haemolytic disease of the newborn, prosthetic valve related

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13
Q

What investigation is done if reticulocytes are increased?

A

Investigate for acute blood loss

Direct antiglobulin test DAGT

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14
Q

What would a + DAGT test signify?

A

Immune cause of haemolysis

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15
Q

What would a - DAGT signify?

A

Non immune cause

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16
Q

What would cause a + warm autoantibody?

A

Usually autoimmune most commonly idiopathic

Other causes- drugs, CLL

17
Q

What would cause a + cold autoantibody?

A

Usually secondary- infection, neoplasm

Occasionally CHAD

18
Q

Would would cause a + alloantibody?

A

Transfusion reaction

19
Q

What would cause a - DAGT?

A

Non immune causes e.g. severe infection, DIC, toxins, drugs, pre-eclampsia

20
Q

What investigation is done of macrocytic anaemia?

A

B12/folate assay

21
Q

What would a megaloblastic anaemia be caused by?

A

B12 or folate deficiency?

22
Q

What are the causes of B12 deficiency?

A

Pernicious anaemia

Gastric/ileal disease

23
Q

What is pernicious anaemia?

A

Autoimmune, common cause of B12 defieicny

Present with lemon yellow tinge

24
Q

What causes folate deficiency?

A

Dietary
Increased requirement e.g. haemolysis
GI

25
Q

What is the management of B12/folate deficiency?

A

B12 IM injection every 3 months

Oral folate

26
Q

What causes non-megaloblastic macrocytic anaemia?

A

Myelodysplasia
Drugs- esp alcohol
Marrow infiltration

27
Q

What is anaemia of chronic disease?

A

Normochronic normocytic or slightly hypo chromic microcytic anaemia
Inflammation induced reduction in RBCs

28
Q

What is the mechanism of anaemia of chronic disease?

A

Inflammation –> hepcidicn production –> decreased iron absorption –> decreased plasma iron –> decreased RBC production

29
Q

What causes anaemia of chronic disease?

A

Chronic infection- TB, HIV, hepatitis
Malignancy
Connective tissue disease- RA, SLE, IBD

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