Anaemia Flashcards
What is anaemia?
A reduction in the haemoglobin concentration of the blood
What are the symptoms of anaemia?
Shortness of breath on exercise
Weakness and lethargy
Palpitations and headaches
Cardiac failure, angina, intermittent claudication and confusion
Visual disturbances due to retinal haemorrhage
What are the signs of anaemia?
Pallor
Hyperdynamic circulation, tachycardia, bounding pulse, cardiomegaly
Congestive cardiac failure
Retinal haemorrhages
What are the causes of anaemia?
Lack of ingredients to make haemoglobin (iron, B12 or folic acid)
Failure of the blood marrow to make red cell (aplastic anaemia or replacement of the bone marrow by tumour)
Loss of blood
Destruction of red cells
What are the classifications of anaemia?
Microcytic (MCV <80, MCH <27- iron deficiency)
Normocytic (MCV 80-100, MCH >36- after acute blood loss, renal disease)
Macrocytic (MCV >100- megaloblastic- vitamin B12 or folate deficiency, non-megaloblastic- alcohol, liver disease)
What is the treatment for iron deficiency anaemia?
Oral iron supplement- ferrous sulphate 200mg 3x a day
What is pernicious anaemia?
A deficiency in the production of red blood cells through a lack of vitamin B12
What is the treatment for macrocytic anaemia?
Vitamin B12 injections
Folic acid
What is leukaemia?
Cancer of the blood cells
What is the classification of leukaemia?
Acute myeloid leukaemia M0-M7
Acute lymphoblastic L1-L3
Chronic myeloid leukaemia
Chronic lymphoid leukaemia
What is the classification of acute myeloid leukaemia?
M0- differentiated M1- without maturation M2- with granulocytic maturation M3- acute promyelocyctic M4- granulocyctic with monocyctic maturation M5- monoblastic M6- erythroblastic M7- megakaryoblastic
What is the classification of acute lymphoblastic leukaemia?
L1- small blasts with high nuclear cytoplasmic ratio
L2- larger heterogenous blasts
L3- vacuolated, basophilic blasts
What are the signs of leukaemia?
Tissue infiltration Bone marrow failure Anaemia Infection Thrombocytopenia Skin infection Gum infiltration Oral candidiasis
What is lymphoma?
Lymphoma is a type of cancer that affects the lymphatic system where malignant lymphocytes accumulate in lymph nodes
What are the two types of lymphoma?
Hodgkin’s lymphoma (Reed Sternberg cells)
Non-Hodgkin’s lymphoma
What are the constitutional symptoms of Hodgkin’s lymphoma?
Fever Weight loss Anorexia Pruritis Night sweats Fatigue
What are the clinical findings of Hodgkin’s lymphoma?
Cervical lymphadenopathy Mediastinal mass Painless, firm, discrete lymph nodes Hepatosplenomegaly Superior venacaval obstruction
What is the treatment of Hodgkin’s lymphoma?
Combination therapy (MOPP, ABVD, Stanford V)
Autologous stem cell transplantation
Targeted immunotherapy
What are the clinical symptoms of Non-Hodgkin’s lymphoma?
Lymphadenopathy
Constitutional symptoms
Oropharyngeal involvement
Abdominal disease
What is the treatment of Non-Hodgkin’s lymphoma?
High grade- aggressive treatment with possibility of cue
Low grade- treatment controls disease, may have long survival
What is multiple myeloma?
Clinical proliferation of plasma cells
What are the signs of multiple myeloma?
Bone marrow failure Bone disease Paraprotein Renal failure Hypercalcaemia
What is the treatment of multiple myeloma?
Resuscitation (steroids, fluid, renal support, transfusion)
Oral chemotherapy
Thalidomide, bortizimab
Autologous stem cell transplantation
Relapse- lenalidomide, pomolidamide, carfilzomib
Daratumab
