Anaemia

Question 1

What is anaemia?

Answer 1

Reduction in haemoglobin in the blood

Question 2

Normal hemoglobin level

Answer 2

12.5 - 15.5 g/dl

Question 3

If Hb level is low?

If Hb level is high?

Answer 3

• If lower = anaemia
• If higher = polycthaemia (caused by smoking, lung diseases, inefficient lungs meaning less O2 is exchanged so more haemoglobin is required etc.)

Question 4

Describe iron deficiency anaemia

Answer 4

Iron is needed for haemoglobin production, lack of iron results in the reduced production of small red cells

Question 5

What is red cell size measured as?

What is the normal?

Answer 5

MCV (mean cell volume)

normal = 82 - 96 fl

Question 6

In iron deficiency anaemia, what is there low of and MCV level?

Answer 6

low haemoglobin and MCV < 80 fl

Question 7

What is macrocytic anaemia?

What is it due to?

Answer 7

normal red blood cell size = 82-96 fl, in macrocytosis
anaemia = > 100 fl (large red blood cells)

occurs due to a vitamin B12 or folate deficiency

Question 8

What is vitamin B12 & folate needed for?

Answer 8

DNA sysnthesis

Question 9

B12 and folate deficiency cause what?

Answer 9

Red blood cells cannot be made in the bone marrow and therefore, less are released, resulting in anaemia

Question 10

Why will vitamin 12 and folate deficiency affect bone marrow most?

Answer 10

This deficiency will affect all dividing cells, but bone marrow is most active so is affected first

Question 11

What are the 2 causes of B12 deficiency?

Answer 11

Stomach damage

Pernicious anaemia

Question 12

How does stomach damage cause B12 deficiency?

Answer 12

In the terminal ileum B12 absorption occurs

Intrinsic factor PRODUCED BY THE GASTRIC PARIETAL CELLS IN THE STOMACH is required for absorption to occur since B12 binds to intrinsic factor and is THEN absorbed

Thus if the stomach is damaged can result in less parietal cells thus less intrinsic factor thus less B12 absorbed thus anaemia

Question 13

How does pernicious anaemia cause B12 deficiency?

Answer 13

An autoimmune disease called PERNICIOUS ANAEMIA, causes the antibodies to be made against gastric parietal cells meaning less intrinsic factor can be produced so there is B12 malabsorption and thus ANAEMIA

However the liver have a vast store of B12 which can last 4 years, thus pernicious anaemia has a slow onset

Question 14

What is haemolysis?

Answer 14

Normal or increased cell production but DECREASED LIFE SPAN < 30 DAYS, red blood cells are destroyed before their 120 day lifespan

Question 15

What are the causes of congenital haemolysis?

Answer 15

Membrane issues, enzyme issues, Hb issues

Eg, spherocytosis, bc are spherical and get stuck in vessels

Pyruvate kinase deficiency - enzyme required to convert phosphoenolpyruvate to pyruvate is deficient, resulting is less ATP production

Sickle cell anaemia