Anaemia

Question 1

Causes of anaemia in infancy

Answer 1

Physiologic anaemia of infancy, anaemia of prematurity, blood loss, haemolysis, twin-twin transfusion

Question 2

Causes of haemolysis in infancy

Answer 2

Haemolytic disease of newborn (ABO or rhesus incompatibility), hereditary spherocytosis, G6PD deficiency

Question 3

What is physiologic anaemia of infancy

Answer 3

Normal dip in haemoglobin around 6-9 weeks of age in healthy term babies

Question 4

Reasons for anaemia in premature babies

Answer 4

Less time in utero for recieving iron from the mother, RBC creation cannot keep up with the rapid growth in first few weeks, reduce erythropoietin levels, blood tests remove significant portion in circulating volume

Question 5

Test for haemolytic disease of newborn

Answer 5

Direct Coombes test (DCT)

Question 6

Common causes of anaemia in older children

Answer 6

Iron deficiency secondary to dietary insufficiency, blood loss from menstruation

Question 7

Rarer causes of anaemia in children

Answer 7

Sickle cell, thalassaemia, leukaemia, hereditary spherocytosis, hereditary eliptocytosis, sideroblastic anaemia

Question 8

Causes of normocytic anaemia (5)

Answer 8

3 A’s 2 H’s
Acute blood loss
Anaemia of chronic disease
Aplastic anaemia
Haemolytic anaemia
Hypothyroidism

Question 9

Causes of microcytic anaemia (5)

Answer 9

TAILS
Thalassaemia
Anaemia of chronic disease
Iron deficiency anaemia
Lead poisoning
Sideroblastic anaemia

Question 10

Types of macrocytic anaemia

Answer 10

Megaloblastic and normoblastic

Question 11

What is megaloblastic anaemia

Answer 11

Result of impaired DNA synthesis preventing cell from dividing normally. Caused by vitamin deficiency

Question 12

Causes of megaloblastic macrocytic anaemia

Answer 12

B12 deficiency and folate deficiency

Question 13

Causes of normoblastic macrocytic anaemia

Answer 13

Alcohol, reticulocytosis, hypothyroidism, liver disease and drugs such as azithioprine

Question 14

Symptoms of anaemia

Answer 14

Tiredness, SOB, headaches, dizziness, palpitations, worsening of other conditions, specific to iron deficiency anaemia is pica and hair loss

Question 15

Signs of anaemia

Answer 15

Pale skin, conjunctival pallor, tachycardia, raised resp rate

Question 16

Specific symptoms of iron deficiency anaemia

Answer 16

Pica, hair loss, koilonychia, angular chelitis, atrophic glossitis, brittle hair and nails

Question 17

When is Hb lowest

Answer 17

Gradually falls over first few weeks of life and is lowest at around 2 months of age

Question 18

General causes of anaemia

Answer 18

Reduced red cell production
Increased red cell destruction
Blood loss

Question 19

Causes of impaired RBC production

Answer 19

Red cell aplasia
Ineffective erythropoiesis

Question 20

Causes of increased RBC destruction

Answer 20

Red cell membrane disorders
Red cell enzyme disorders
Haemoglobinopathies
Immune

Question 21

Causes of blood loss

Answer 21

Feto-maternal bleeding
Chronic GI blood loss
Inherited bleeding disorders

Question 22

Blood results indicating iron deficiency anaemia

Answer 22

Low serum iron
High transferrin
Low transferrin saturation
Low ferritin
High soluble transferrin receptor

Question 23

Blood results of anaemia of chronic disease

Answer 23

Low serum iron, transferrin, transferrin saturation
Normal ferritin and soluble transferrin receptor

Question 24

Blood results of iron overload

Answer 24

High serum iron, transferrin caturation, ferritin
Low or normal transferrin
Low soluble transferrin receptor