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Year 4 > Anaemia > Flashcards

Anaemia Flashcards

1
Q

what type of anaemia is iron deficiency?

A

microcytic (low MCV)

hypochromatic (low MCHC)

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2
Q

most common cause of iron deficiency anaemia?

A

blood loss

  • menstruation
  • GI bleed (often malignancy)
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3
Q

what type of anaemia is B12/folate deficiency?

A

macrocytic

megaloblastic

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4
Q

whats the difference between macrocytic and megaloblastic?

A 
macrocytic = high MCV
megaloblastic = high/normal MCHC
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5
Q

what is MCHC?

A

measure of concentration of haemoglobin within a blood cell?

so is normal in B12/folate deficiency as its nuclear maturation thats affected not Hb??

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6
Q

what to megaloblastic RBCs look like on blood film?

A

hypersegmented neutrophils

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7
Q

what can cause B12/folate deficiency?

A 
pernicious anaemia (B12)
malbsorption (B12 or folate)
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8
Q

how does B12/folate deficiency result in anaemia?

A

B12 and folate needed for DNA synthesis

deficiency results in large erythroblasts with immature nuclei (megaloblasts)

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9
Q

features of aplastic anaemia on blood tests?

A

pancytopaenia (low RBCs, WBCs and platelets)

low Hb

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10
Q

bone marrow features of aplastic anaemia?

A

hypocellular bone marrow with no abnormal cells

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11
Q

what can cause aplastic anaemia?

A

bone marrow failure of any cause really

eg - idiopathic, drugs, viral illness, inherited forms such as fanconi anaemia

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12
Q

most common anaemia in alcoholics?

A

B12/folate (macrocytic megaloblastic)

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13
Q

most common anaemia in otherwise well people who drink a lot of alcohol?

A

macrocytic non-megaloblastic

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14
Q

what can cause non-megaloblastic macrocytic anaemia?

A 
macocytosis in excess alcohol drinkers
hypothyroidism
hepatic disease
haemolytic anaemia
myelodysplastic syndrome
drugs
asplenia
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15
Q

features of autoimmune haemolytic anaemia on blood tests?

A

normocytic (normal MCV)
normochromatic (normal MCHC)
low Hb
unconjugated hyperbilirubinaemia

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16
Q

what features on blood film indicate haemolysis (eg in autoimmune haemolytic anaemia)?

A

spherocytes
high reticulocyte count
(also high unconjugated bilirubin but not really seen on blood film)

17
Q

how can autoimmune haemolytic anaemia be diagnosed?

A

direct antiglobulin test (direct coombs test) - shows auto-antibodies on surface of RBCs if positive

18
Q

what is fanconi’s anaemia?

A

increased chromosomal breakage, rearrangements and deletions due to defective DNA repair

19
Q

who is fanconi’s anaemia more common in?

A

people of ashkenazi jewish descent

20
Q

physical features of fanconi’s anaemia?

A 
abnormal/absent thumbs
kidney malformations
microcephaly
hypogonadism
high foetal Hb
21
Q

features of fanconi’s anaemia on blood film?

A

aplastic anaemia

pancytopaenia

22
Q

in which conditions can anaemia of chronic disease occur?

A

active malignancy

chronic conditions such as diabetes or RA

23
Q

blood features of anaemia of chronic disease?

A

can be normocytic or microcytic
high ferritin
reduced total iron binding capacity
low Hb (but rarely below 8)

24
Q

anaemia of chronic disease is basically the same as what other anaemia and how can they be separated?

A

basically same as iron deficiency

differentiated by presence of high ferritin and low TIBC in anaemia of chronic disease

25
Q

why is ferritin high in anaemia of chronic disease?

A

secondary to underlying inflammatory process

26
Q

how is anaemia of chronic disease diagnosed?

A

presence of chronic inflammatory disease and anaemia

blood features

27
Q

how is anaemia of chronic disease managed?

A

treat underlying disorder
monitor Hb
blood transfusion in severe cases

28
Q

what is hereditary spherocytosis?

A

condition where the RBCs are sphere shaped making them fragile and easily destroyed
most common inherited haemolytic anaemia in north europe

29
Q

how is hereditary spherocytosis inherited?

A

AD

30
Q

how does hereditary spherocytosis present?

A 
jaundice (unconjugated bilirubin in all haemolytic anaemias)
anaemia
gallstones
splenomegaly
can have episodes of haemolytic crisis
31
Q

what can cause haemolytic crisis in hereditary spherocytosis and what happens?

A

can be triggered by infection

causes more severe haemolysis, anaemia and jaundice

32
Q

what is an aplastic crisis in hereditary spherocytosis?

A

where patients develop increased haemolysis, anaemia and jaundice without the normal bone marrow response of creating new RBCs (ie no reticulocytosis)

33
Q

what often triggers aplastic crisis in hereditary spherocytosis?

A

parovirus infection (aplastic crisis after parovirus infection = buzzword for hereditary spherocytosis)

34
Q

how is hereditary spherocytosis diagnosed?

A 
fam history
clinical features
spherocytes on blood film
raised MCHC (megaloblastic?)
reticulocytes can be raised due to rapid turnover of RBCs
35
Q

how is hereditary spherocytosis managed?

A

folate supplementation
splenectomy (stops destruction of fragile RBCs as they pass through the spleen?)
removal of gallbladder (if gallstones are a problem)
transfusions may be needed during acute crises

Year 4 (83 decks)

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