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4. Ageing > Anaemia > Flashcards

Anaemia Flashcards

1
Q

What is anaemia?

A

Anaemia is present when there is a decrease in Hb in the blood below the reference level for the age and sex of the individual

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2
Q

What are normal Hb values for men?

A

13.5 to 17.5 grams per deciliter

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3
Q

What are normal Hb values for women?

A

12.0 to 15.5 grams per deciliter

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4
Q

What factors would you use to classify anaemia?

A

Hb serum values
Mean corpuscular volume
Appearance of red blood cells

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5
Q

What are the different types of macrocytic anaemia?

Macrocytic anemia is a type of anemia that causes unusually large red blood cells

A

Vitamine B12 deficiency, folate deficiency (megaloblastic)

Alcohol, liver disease, hypothyroidism, drug therapy (normoblastic)

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6
Q

What are the different types of anaemia related to microcytes?

A

Iron deficiency
Anaemia of chronic disease
Thalassaemia

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7
Q

What are the different types of anaemia related to normal-sized cells?

A

Acute blood loss
Anaemia of chronic disease
Chronic Kidney disease
Autoimmune rheumatic disease

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8
Q

What are the symptoms of anaemia?

A
  • Fatigue, headaches and faintness
  • Breathlessness
  • Angina
  • Intermittent claudication
  • Palpitations.
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9
Q

What are the signs of anaemia?

A
  • Pallor
  • Tachycardia
  • Systolic flow murmur
  • Cardiac failure
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10
Q

What investigations would you do if you suspected anaemia?

A
  • Red cell indices
  • White blood cell count
  • Platelet countThe reticulocyte count (as this indicates marrow activity)
  • The blood film, as abnormal red cell morphology
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11
Q

What are causes of iron deficient anaemia?

A 
Inadequate intake
Being unable to absorb iron
H. pylori 
Chronic blood loss due to frequent or heavy periods in women or by gastrointestinal (GI) bleeds from upper GI ulcers or inflammatory bowel disease
Pregnancy
Blood loss
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12
Q

What are the signs of iron deficient anaemia?

A
  • Brittle nails
  • Spoon-shaped nails (koilonychia)
  • Atrophy of the papillae of the tongue
  • Angular stomatitis
  • Brittle hair
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13
Q

How would you manage iron-deficient anaemia?

A

Iron supplements

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14
Q

What iron supplements could you give to treat iron-deficient anaemia?

A

Ferrous fumarate 200mg
Ferrous gluconate 300mg
Ferrous sulfate 300mg

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15
Q

What are two main types of anaemia?

A
  1. Microcytic anaemia

2. Macrocytic anaemia

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16
Q

What is the cause of anaemia of chronic disease?

A

Chronic inflammation

Characterised by anaemia and evidence of immune system activation

17
Q

What are risk factors for anaemia of chronic disease?

A

autoimmune disorders
malignancy
acute or chronic infection
critical illness, major trauma, or major surgery with delayed recovery

18
Q

What biochemical values do you often find in anaemia of chronic disease?

A

The serum iron and the TIBC are low, and the serum ferritin is normal or raised because of the inflammatory process

19
Q

How would you treat anaemia of chronic disease?

A

Don’t respond to iron therapy: treat the underlying cause!

20
Q

What are the main two types of macrocytic anaemia?

A
  1. Megaloblastic
  2. Non-megaloblastic

Megaloblastic macrocytosisis the most common form. It occurs when DNA cannot be produced because of a vitamin deficiency.

21
Q

What is the main cause of macroblastic, non-megaloblastic, anaemia?

A

Pregnancy

22
Q

What are megaloblasts, as seen in anaemia?

A

Megaloblastic anaemia is characterised by the presence in the bone marrow of erythroblasts with delayed nuclear maturation because of defective DNA synthesis (megaloblasts)

23
Q

What are the most common causes of macroblastic megaloblastic anaemia?

A

Vitamin B12 or folate deficiency
Congenital enzyme deficiencies in DNA synthesis
Drugs interfering with DNA synthesis

24
Q

What is the normal reference value for the mean corpuscular volume in anaemia?

A

80-100fL

25
Q

What is the mean corpuscular value (on average) as seen in macrocytotic anaemia?

A

> 95fL

26
Q

How would you treat macroblastic megaloblastic anaemia?

A

Vitamin injections

27
Q

What is pernicious anaemia?

A

Pernicious anaemia (PA) is an autoimmune disorder in which there is atrophic gastritis with loss of parietal cells in the gastric mucosa with consequent failure of intrinsic factor production and vitamin B12 malabsorption.

28
Q

How would you treat vitamin B12-deficient anaemia?

A

Hydroxocobalamin 1000 μg can be given intramuscularly to a total of 5–6 mg over the course of 3 weeks

1000 μg is then necessary every 3 months for the rest of the patient’s life

29
Q

How would you treat vitamin folate-deficient anaemia?

A

Folate deficiency can be corrected by giving 5 mg of folic acid daily

Treatment should be given for about 4 months to replace body stores

4. Ageing (12 decks)

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