Anaemia 1 Flashcards
what is anaemia
a reduction in haemoglobin in the blood from the normal values for that population
what can haemoglobin issues be?
inability to make the haem or inability to make the correct globin chains
what does the size of red blood cells give a clue to?
the cause of anaemia
what are the causes of anaemia
reduced population, increased losses, increased demand
what is a reduced normal red cell amount due to?
marrow failure
what is reduced Hb amount due to?
deficiency, abnormal globin chains, chronic inflammatory disease
what is the reason for abnormal globin chains?
thalassemia and sickle cell anaemia
histologically, what does aplastic marrow present as?
white puffy cells
what are haematinics?
things used to make the red blood cells
what are the haematinics?
iron, vitamin B12, folic acid
what are the sources of iron
meat, green leafy vegetables, iron tablets
how is iron absorbed?
converted from non-haem iron (Fe3+) to haem iron (Fe2+) and once absorbed it is then converted back to Fe3+
which diseases reduce iron absorption?
achlorhydria and coeliac disease
what is achlorhydria?
lack of stomach acid so there is no conversion of non-haem iron
what causes achlorhydria?
possibly drug induced by proton pump inhibitors
how is iron lost?
gastric erosions and ulcers, inflammatory bowel disease, bowel cancer, haemorrhoids
name the 2 types of IBD
crohn’s disease, ulcerative colitis
what are the 2 types of bowel cancer?
colonic cancer and rectal cancer
what are the sources of vitamin B12?
diary, eggs, meat and fish
where is vitamin B12 absorbed?
the terminal ileum
apart from food what is also a source of vitamin B12?
it is secreted by intrinsic factor from parietal cells
how do you get vitamin B12 deficiency?
lack of intake (vegans), lack of intrinsic factor, disease of terminal ileum
what causes a lack of intrinsic factor?
autoimmune stomach disease - pernicious anaemia, gastric disease
what causes a disease of the terminal ileum?
crohn’s disease
