Anaemia Flashcards
Name 3 components of the full blood count
- Haemoglobin
- White cell count
- Platelet count
Describe 5 components of the normal adult red cell values
- Haemoglobin
- Haematocrit
- Red cell count
- Mean cell haemoglobin
- Mean cell volume
Name 5 types of white blood cells in order of most to least common
- Neutrophil
- Lymphocytes
- Monocytes
- Eosinophils
- Basophils
What is the normal range of platelet count?
150-400 x 10⁹/l
What is the normal range of total leucocytes in the white cell count?
4-11 x 10⁹/l
What is anaemia?
A reduction in haemoglobin concentration in the blood, resulting in decreased oxygen carrying capacity
Name 5 common symptoms of anaemia
1 .Shortness of breath on exercise
- Weakness and lethargy
- Palpitations and headaches
- Cardiac failure or angina
- Visual disturbances
Name 4 signs of anaemia
- Pale pallor
- Hyperdynamic circulation, tachycardia
- Congestive cardiac failure
- Retinal haemorrhages
Name 4 causes of anaemia
- Lack of ingredients to make haemoglobin
- Failure of blood marrow to make red cells
- Loss of blood (bleeding)
- Destruction of red cells
Name 3 ingredients needed to make haemoglobin
- Iron
- Vitamin B12
- Folic acid
Name 3 types of anaemia with regards to classification
- Microcytic hypochromic
- Normocytic normochromic
- Macrocytic
What is MCV?
- Mean cell volume
- The size of a cell
What is MCH?
- Mean cell haemoglobin
- Amount of haemoglobin present
Describe MCV and MCH in microcytic anaemia
- MCV < 80fl
- MCH < 27pg
Name 5 possible causes of microcytic anaemia
- Iron deficiency
- Thalassaemia
- Anaemia of chronic diseases
- Lead poisoning
- Sideroblastic anaemia
Describe MCV and MCH in normocytic anaemia
- MCV 80-100fl
- MCH > 26pg
Name 5 possible causes of normocytic anaemia
- Anaemia of chronic diseases
- Acute blood loss
- Renal disease
- Bone marrow failure
- Haemolytic anaemias
Describe the MCV of macrocytic anaemia
MCV > 100fl
Name 2 types of macrocytic anaemia
- Megaloblastic
2. Non-Megaloblastic
Name 2 causes of megaloblastic macrocytic anaemia
- Vitamin B12 deficiency
2. Folate deficiency
Name 4 causes of non-megaloblastic macrocytic anaemia
- Alcohol
- Liver disease
- Myelodysplasia
- Aplastic anaemia
Highlight the major differences between microcytic, normocytic and macrocytic anaemia
Microcytic - Cells present are too small
Normocytic - Reduced numbers of cells present but cells which are present are normal
Macrocytic - Cells are bigger than normal so divide abnormally so not enough cells present in blood
Describe how an iron deficiency is treated
Oral supplement e.g ferrous sulphate 200mg TID on an empty stomach
Describe 5 clinical symptoms of megaloblastic anaemia
- Insidious onset of symptoms
- Lemon yellow jaundice
- Glossitis and angular stomatitis
- Purpura (bruising)
- Neuropathy (subacute) combined with degeneration of cord
Describe pernicious anaemia
- Autoimmune attack on the gastric mucosa leading to atrophy of the stomach
- F > M
- Tends to occur in families
What happens to neutrophils during macrocytic anaemia?
They become hypersegmented as they grow more before dividing
What are 2 treatment options for macrocytic anaemia?
- Vitamin B12 injections
2. Folic acid
Name 4 classifications of leukaemia
- Acute myeloid leukaemia M0-M7
- Acute lymphoblastic L1-L3
- Chronic myeloid leukaemia
- Chronic lymphoid leukaemia
Describe the classification of acute myeloid leukaemia
M0 - Undifferentiated M1 - Without maturation M2 - With granulocytic maturation M3 - Acute promyelocytic M4 - Granulocytic with monocytic maturation M5 - Monoblastic M6 - Erythroblastic M7 - Megakaryoblastic
Describe the classification of acute lymphoblastic leukaemia
L1 - Small blasts with high nuclear cytoplasmic ratio
L2 - Large heterogenous blasts
L3 - Vacuolated basophilic blasts
Name 5 clinical signs of acute leukaemia
- Tissue infiltration
- Bone marrow failure
- Anaemia
- Infection
- Thrombocytopaenia
Name 3 commonly seen infections during acute leukaemia
- Cellulitis
- Oral candidiasis
- Gum infection and swelling
What are lymphomas?
Malignant lymphocytes which accumulate in the lymph nodes and may spill out into peripheral blood
What is the marker of Hodgkin’s lymphoma?
Reed Sternberg cells
Name 5 symptoms of Hodgkin’s disease
- Fever
- Pruritis
- Weight loss
- Night sweats
- Fatigue
Describe the clinical implications of Hodgkin’s dsiease
- Peak incidence in young adults and elderly
- M:F 2:1
- Painless firm discrete lymph nodes
- Hepatosplenomegaly
- Mediastinal and other organ involvement
What is the biggest concern with mediastinal involvement in Hodgkin’s disease?
Superior vena cava obstruction
Name 3 types of treatment for Hodgkin’s lymphoma
- Combination chemotherapy
- Autologous stem cell transplantation
- Targeted immunotherapy
Name 5 clinical implications of non-Hodgkin lymphoma
- Lymphadenopathy
- Constitutional symptoms
- Oropharyngeal involvement
- Bone marrow failure
- Abdominal disease
Describe treatment focus on high and low grade non-Hodgkin lymphoma
High - Aggressive treatment with possibility of cure
Low - Treatment to control disease
What is the most common haematological malignancy?
Multiple myeloma
Describe multiple myeloma
- Clonal proliferation of plasma cells
- Bone marrow failure
- Bone disease (lytic lesions)
- Renal failure and hypercalcaemia
What happens during multiple myeloma with regards to plasma cells?
Plasma cells proliferate without checks and begin to invade other parts of the blood and take over e.g peripheral blood, bone marrow
Describe the treatment options of multiple myeloma
- Resuscitation (steroids, fluid, renal support)
- Oral chemotherapy
- Bisphosphonates
- ASCT
