Anaemia (1*)

Question 1

How do Hb levels change after birth?
→ Why does this happen?

Answer 1

High at birth, and decreases over time
→ High O2 delivery by the high Hb levels causes a negative feedback → Less EPO production → Less Hb

Question 2

What are the causes in infancy?

Answer 2

• Haemolysis
‣ Haemolytic Disease of the Newborn
‣ Hereditary spherocytosis (abnormal rbc shape i.e. spherical)
‣ G6PD deficiency
• Blood loss
• Anaemia of prematurity
• Twin-twin transfusion – Blood unequally distributed between twins in womb

Question 3

What is the most common cause in older children?

What are the other causes?

Answer 3

➊ Dietary insufficiency

➋ • Blood loss – Most frequently menstruation in older girls
• Sickle cell, Thalassaemia, Leukaemia

Question 4

Which investigations should be done?

Answer 4

• Bloods - FBC (Hb, MCV), Reticulocyte, Ferritin, B12, Folate, Bilirubin
• Blood film
• Direct Coombs test