Anaemia 1

Question 1

what is anaemia

Answer 1

a reduction in haemoglobin in the blood from the normal values for that population

Question 2

what can haemoglobin issues be?

Answer 2

inability to make the haem or inability to make the correct globin chains

Question 3

what does the size of red blood cells give a clue to?

Answer 3

the cause of anaemia

Question 4

what are the causes of anaemia

Answer 4

reduced population, increased losses, increased demand

Question 5

what is a reduced normal red cell amount due to?

Answer 5

marrow failure

Question 6

what is reduced Hb amount due to?

Answer 6

deficiency, abnormal globin chains, chronic inflammatory disease

Question 7

what is the reason for abnormal globin chains?

Answer 7

thalassemia and sickle cell anaemia

Question 8

histologically, what does aplastic marrow present as?

Answer 8

white puffy cells

Question 9

what are haematinics?

Answer 9

things used to make the red blood cells

Question 10

what are the haematinics?

Answer 10

iron, vitamin B12, folic acid

Question 11

what are the sources of iron

Answer 11

meat, green leafy vegetables, iron tablets

Question 12

how is iron absorbed?

Answer 12

converted from non-haem iron (Fe3+) to haem iron (Fe2+) and once absorbed it is then converted back to Fe3+

Question 13

which diseases reduce iron absorption?

Answer 13

achlorhydria and coeliac disease

Question 14

what is achlorhydria?

Answer 14

lack of stomach acid so there is no conversion of non-haem iron

Question 15

what causes achlorhydria?

Answer 15

possibly drug induced by proton pump inhibitors

Question 16

how is iron lost?

Answer 16

gastric erosions and ulcers, inflammatory bowel disease, bowel cancer, haemorrhoids

Question 17

name the 2 types of IBD

Answer 17

crohn’s disease, ulcerative colitis

Question 18

what are the 2 types of bowel cancer?

Answer 18

colonic cancer and rectal cancer

Question 19

what are the sources of vitamin B12?

Answer 19

diary, eggs, meat and fish

Question 20

where is vitamin B12 absorbed?

Answer 20

the terminal ileum

Question 21

apart from food what is also a source of vitamin B12?

Answer 21

it is secreted by intrinsic factor from parietal cells

Question 22

how do you get vitamin B12 deficiency?

Answer 22

lack of intake (vegans), lack of intrinsic factor, disease of terminal ileum

Question 23

what causes a lack of intrinsic factor?

Answer 23

autoimmune stomach disease - pernicious anaemia, gastric disease

Question 24

what causes a disease of the terminal ileum?

Answer 24

crohn’s disease

Question 25

what are the sources of folic acid?

Answer 25

leafy vegetables and bell peppers

Question 26

what causes folic acid defiency?

Answer 26

lack of intake, absorption failure

Question 27

what causes absorption failure with folic acid?

Answer 27

jejunal disease due to coeliac disease

Question 28

what can folic acid deficiency lead to?

Answer 28

neural tube defect in foetus

Question 29

what is thalassemia?

Answer 29

genetic mutation of globin chains

Question 30

what are the clinical effects of thalassemia?

Answer 30

chronic anaemia, marrow hyperplasia, splenomegaly, cirrhosis, gallstones

Question 31

how do you manage thalassemia?

Answer 31

blood transfusions, prevent iron overload

Question 32

what is sickle cell anaemia?

Answer 32

abnormal globin chains changing shape in low oxygen environments

Question 33

what does the sickle shape of RBCs in sickle cell anaemia cause?

Answer 33

prevention of RBC passing through the capillaries, tissue ischaemia (pain and necrosis)