Anaemia

Question 1

1. Define Anaemia
2. Name the two means of measuring this in practice
3. Erythroid precursors arise around a _______ ________ in the bone marrow.

Answer 1

1. Reduced total Red Blood cell mass
2. Haemoglobin and Haematocrit measurements.
3. Nursing Histiocyte

Question 2

1. Identify two scenarios in which Hb/Hct is a poor marker of anaemia.
2. What is reticulocytosis?
3. How do reticulocytes differ from erythrocytes?

Answer 2

1. Blood loss and plasma expansion (haemodilution occurs)
2. Increase in red blood cells
3. Retain RNA, larger, stain purple/deep red because of retained RNA (Polychromatic)

Question 3

1. Haemoglobin synthesis occurs in the ___________ of red cell precursors. Defects result in _____ cells. Because of the lack of haemoglobin they are ________ in colour.
2. Haem or Globin deficiency are the causes of microcytic anaemia. What 5 causes come under these two headings?
3. Iron is transported in the blood attatched to ________ whereas it is stored in storage tissues such as the liver as _______ which is also found in the blood giving an estimate of the storage.

Answer 3

1. Cytoplasm, microcytic (small), Hypochromic
2. Thalassaemia,
   Anaemia of Chronic Disease,
   Iron Deficiency,
   Lead Poisoning,
   Sideroblastic anaemia
   (TAILS)
3. Transferrin, Ferritin.

Question 4

1. Negative iron balance results in exhaustion of iron stores (_______ falls), thus iron deficient erythropoiesis (_____ falls), thus ______ anaemia develops. Symptoms such as skin and nail changes follow.
2. What are the three causes of Iron deficiency?
3. Iron is absorbed in the _______ small bowel.

Answer 4

1. Ferritin, MCV, Microcytic
2. Insufficient dietary iron, Losing iron (blood loss), Malabsorption.
3. Proximal

Question 5

1. Define Macrocytic anaemia
2. How is red cell volume measured?
3. What units are used?

Answer 5

1. Red cell loss in which the red cells have a larger than normal volume
2. MCV (Mean Corpuscular Volume)
3. Femtolitres

Question 6

1. Name two nucleated cell types that are red cell precursors.
2. What is a megaloblast?
3. _________ anaemia is characterised by larger ______ cells with an immature nucleus leading to macrocytic anaemia.

Answer 6

1. Erythroblasts, normoblasts.
2. An abnormally large nucleated red cell precursor with an immature nucleus
3. Megaloblastic, precursor

Question 7

1. What factor is needed for the absorption of Vitamin B12? Where does this occur?
2. ______ anaemia (PA) is an ________ condition with resulting destruction of gastric ________ cells. This results in ______ factor deficiency with B12 malabsorption and deficiency.

Answer 7

1. Intrinsic Factor, Ilium

2. Pernicious, autoimmune, parietal, intrinsic

Question 8

1. Vitamin B12 is found in ________ products. It is stored for _____ years. It is absorbed in the ______. the daily requirement is ____ per day.
2. Folate is found in ________ products. It is stored for _____ months. It is absorbed in the _______. The daily requirement is _____ per day.
3. What symptom is customary to both?
4. What clinical feature is characteristic of folate deficiency?

Answer 8

1. Animal, 2-4 years, ilium, 1.5 micrograms
2. Plant, 4 months, jejunum, 200 micrograms
3. jaundice
4. Neurological problems

Question 9

1. Identify the two main characteristic laboratory findings for a diagnosis o Folate/B12 deficiency
   2.

Answer 9

1. Pancytopenia, hypersegmented neutrophils

Question 10

1. Oral Ferrous _______, Ferrous ________ and Ferrous _______ are used to treat Microcytic anaemia.
2. In Children Ferrous _________ is used which is in liquid form.
3. Most side effects effect the ______ system.
4. When are IV preparations used?

Answer 10

1. Sulfate, glucamate, fumerate,
2. eredetate
3. Gastrointestinal
4. When oral is unsuccessful

Question 11

1. How is pernicious anaemia treated?
2. How is folic acid deficiency treated?
3. What about life-threatening anaemia?

Answer 11

1. Vitamin B12 injections for life.
2. Folic acid tablets
3. Red Cell Transfusions

Question 12

1. Identify 4 possible causes of non-megaloblastic macrocytosis.
2. Identify three types of marrow failure

Answer 12

1. Alcohol excess, liver disease, hypothyroidism, Marrow failure.
2. Myeloma, aplastic anaemia, Myelodysplasia

Question 13

1. Define Spurious Macrocytosis

2. Identify the different causes of this

Answer 13

1. Where the red cell volume is normal and the MCV is high

2. Reticulocytosis, cold-agglutinins,