acquired anaemias Flashcards
test used to assess morphology of RBC?
blood film
3 groups that can be assessed from blood film
hypochromic microcytic
normchromic normocytic
macrocytic
hypochromic microcytic - next test?
results?
serum ferritin
- low: iron deficiency
- normal/high: thalassemia or secondary anaemia
iron deficiency anaemia
causes?
blood loss - GI bleed, menorrhagia
GI malabsorption
GI malignancy - iron deficient anaemia in the elderly - presume colon cancer
physiology of iron in the body
absorbed in the duodenum
transported via transferin
stored with ferritin
signs of iron def anaemia
koilonychia
atrophic tongue
angular cheilitis
blood results for iron deficient anaemia
low MCV
low ferritin
low transferin
low serum iron
iron deficient anaemia PC that requires ODG
Male with no diet problems
tx for iron deficient anaemia
mild: oral iron
chronic: IV iron
if cardiac symptoms - transfusion
normocytic and normochromic blood film means?
test?
just a reduced number
normal MCV, MCH
reticulocyte count
causes of normocytic normochromic anaemia?
high RCC - haemolytic or blood loss
normal or low RCC - secondary anaemia of chronic disease - DM, CKD
test for macrocytic blood film?
very big cells
increased MCV
test folate/B12
megaloblastic microcytic anaemia cause?
folate or b12 deficiency
non megaloblastic macrocytic
marrow infiltration
myelodysplasia
drugs
if normocytic normochromic anaemia - haemolytic - next test?
DAGT
DAGT stands for and does what?
Direct AntiGlobulin Test
assess if haemolysis is autoimmune or not
if pt is haemolysising what tests will you run?
- FBC, RCC, blood film
- serum conjugated bilirubin
- serum haptoglobulin
positive DAGT - means
extravascular autoimmune haemolysis - within reticuloendothelial system
3 different Abs causing autoimmune haemolysis
- warm auto-Ab; spherocytes
- cold auto-ab: infections
- allo-Ab: TRANSFUSION REACTION
Megaloblastic macrocytic anaemia?
b12 or folate deficiency likely
large erythroblasts due to defective DNA synthesis
more likely b12 or folate deficiency?
folate - as stores run out faster than b12
folate source, absorbed where?
green vegetables
small intestine
causes of folate deficiency
diet GI malabsorption - coeliac GI malignancy increased requirements (pregnancy, haemolysis) folate antagonists: methotrexate
vitamin B12 deficiency - physiology and causes:
absorbed and bound to intrinsic factor in the stomach and absorbed as a complex in the terminal ileum
causes: pernicious anaemia
malabsorption
PC of b12/folate def?
YELLOW TINGE
elevated bilirubin due to fragile, easily friable RBCs
testing for pernicious anaemia?
tx
auto Abs for intrinsic factor
IM B12 - unable to absorb
non megaloblastic causes of macrocytic anaemia
alcohol
drugs
methotrexate
hypothyroidism
