Anaemia Flashcards
Define anaemia
insufficient red cell mass to adequately deliver sufficient oxygen to peripheral tissues
symptoms of anemia
give at least 10 example
- yellow eyes
- pale, cold and yellow skin
- shortness of breath
- weakness
- changed stool color
- fatigue
- dizziness
- fainting
- low blood pressure
- palpitations
- rapid heart rate
- chest pain
- angina
- heart attack
- enlargement in the spleen
state the mechanisms of anaemia
oxygen transport v production of erythropoeitin v RBC production v Haemoglobin concentration
what is a microcytosis and what condition can it cause?
decrease in size of erythrocytes
indicative of
- anaemia
- thalassaemia
- hyperthyroidism
what is macrocytosis and what it result from?
increase in the size of erythrocytes
found in B12 deficiency
result of certain prescription drugs
hypochromia
deficiency of colouration of cells, which caused by a deficit of Hb
What is the use of anisochromia?
used to determine the increased variability of staining
how to diagnosis anaemia
to check on the patient’s reticulocyte response either positive / negative ( the inflammation response from various changes of the tissue cells)
what if MCV < 75fl?
investigate for Fe deficiency
What if MCV > 100fl
Investigate for the vitamin B12 deficiency
What if MCV 75-100fl
investigate for anaemia of chronic disorder
What to check if the reticulocyte response was positive?
investigate for bleeding / haemolytic anaemia
what is the dietary recommendation for iron daily intake?
2mg
what regulates iron absorption into the ciruculation?
Hepcidin
How does hepcidin regulates iron absorption?
it inhibits the protein ferroportin which pumps out the iron
–> reduce the iron level
where is iron absorbed?
duodenum
what is transferrin?
Beta-globulin protein that can carry 2 Fe3+ ions per molecule
Which 2 forms is iron stored in?
Haemosiderin
Ferritin
how haemosiderin be visualised?
perl’s stain
why people develop iron deficiency?
decreased supply of Fe
Increased requirement for Fe
symptoms of Fe deficiency
Glossitis - smooth, inflamed tongue
Koilonychia - spooning fingernails
Angular stromatitis - lesion at the corner of the mouth
Pica
behavioural difficulties
Treatment for Fe deficiency
Dietary changes
Iron supplementation
Macrocytic and megaloblastic
Macrocytic –> large erythrocytes and found in many conditions.
Megaloblastic –> reserved to describe macrocytosis duo to retardation in DNA synthesis
2 uses of vitamin B12 metabolic pathways
Conversion of l-methylmalonyl coenzyme a to succinyl co-enzyme A
methylation of homocysteine to methionine
where is Vitamin B12 absorbed?
terminal ileum
two carrier protein that have a transporter role in Vitamin B12 homeostasis
- Transcobalamin I
- Transcobalamin II
2 important folates
N-5,10-methyleneTHF
N-5-methyleneTHF
What is folates?
chemical belonging to the folic acid family
role of folate
act as single carbon donors/acceptors in a variety of reaction
synthesis of methionine histidine catabolism converts serine to glycine purine synthesis pyrimidine synthesis
where does folate stored in the body
liver
diet consumption of folate
700ug of folate per day with heat labile
Where is the folate absorption in?
upper jejunum
what is the process that folate need to do before getting absorbed
polyglutamate must be converted to monoglutamates
e.g.
folic acids –> N-5-methyleneTHF which circulates freely in the blood
what are essential for the process of producing mature nucleotides?
folate and vitamin B12
deficiency in vitamin B12 can arise from
inadequate dietary intake
malabsorption
increased requirements
failure of utilisation
folate deficiency can cause from
inadequate dietary intake
malabsorption –> crohn’s disease
drug-induced folate deficiency
symptoms of megaloblastic anemia
weak muscles numbness or tingling in hands and feet nausea decreased appetite weight loss irritability lack of energy or tiring easily diarrhoea increased heart rate stomatitis glossitis jaundice
