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CP 1080 > Anaemia > Flashcards

Anaemia Flashcards

1
Q

What are young RBCs called which have a nucleus

A

Erythroblasts

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2
Q

What is enucleation and when does it occur

A

Erythrocyte getting rid of nucleus before leaving bone marrow

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3
Q

What helps keep iron in the ferrous Fe2+ form

A

Ascorbic acid

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4
Q

What are folic acid and vitamin B12 used for

A

In production of the nucleotide base thymine
Essential for production of DNA during erythropoiesis

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5
Q

What does the presence of reticulocytes suggest

A

Bone marrow is active in producing RBCs
Plenty of Iron , folate and vitamin B12 available for erythropoiesis

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6
Q

What is anaemia? What values diagnose it in males vs females?

A

Decreased haemoglobin concentration

Females : below 11.5g/dL
Males : below 13.5 g/dL

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7
Q

Name three types of anaemia

A

Iron deficiency anaemia (microcytic anemia)
Normochromic normocytic anaemia
Macrocytic anaemia

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8
Q

What is anisocytosis?

A

variation in RBC size

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9
Q

What is poikilocytosis

A

variation in RBC shape

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10
Q

What is iron deficiency anaemia also known as

A

Microcytic (hypochromic) anaemia

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11
Q

What is a common feature of iron deficiency anaemia

A

Increased platelet count

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12
Q

What is ferritin

A

Protein in which iron is bound in liver

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13
Q

What are the physical signs of leukaemia

A

Expansions of the abdomen - extramedullary haematopoiesis causes splenomegaly and hepatomegaly

Splenomegaly - enlarged spleen
Hepatomegaly - englarged liver

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14
Q

What is leukaemia?

A

A cancer of white blood cells/leukocytes.
Young abnormal WBCs are spilling out of bone marrow

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15
Q

Why does leukaemia result in increased likelihood for infections

A

WBCs produced are of one clone and therefore unable to respond to a range of infections

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16
Q

Why do leukaemia patients bruise easily?

A

Low platelet count

17
Q

What is normocytic normochromic anemia?

A

RBC’s are normal in size and Hb content, but are too few in number (lack of EPO)
Anaemia caused by another underlying condition

18
Q

Microcytic anaemia

A

Iron deficiency

19
Q

Causes of macrocytic anaemia

A

Dietary deficiency of B12 and folate (folic acid)
Pernicious anaemia: autoimmune disease, B12 is not absorbed.

20
Q

Diagnosis?

A

Microcytic anaemia

21
Q

Causes of microcytic anaemia

A

Iron deficiency can be caused by:
- dietary deficiency of iron (vegetarian diet)
- malabsorption (gastrectomy, coeliac disease)
- chronic blood loss (menstruation, ulceration of stomach or duodenum, colonic carcinoma, hookworm and schistosomiasis)

22
Q

Serum ferritin and transferrin saturation importance in an iron deficiency patient?

A
  • Most of iron is bound up in a protein in the liver called ferritin
  • A Transferrin Saturation of less than 20% suggests iron deficiency anaemia (iron circulates in the blood attached to a plasma protein called transferrin)
  • There is an increased rate of cell division of the red cell precursor cells in an iron-deficient environment leading to the individual cells to be smaller (microcytic anaemia)
23
Q

Diagnosis?

A

Normochromic normocytic anaemia, very high WBC and low PLT indicates acute myeloid leukaemia.

24
Q

Diagnosis?

A

Macrocytic anaemia

25
Q

Why would a patient with macrocytic anaemia experience pins + needles?

A
  • Vitamin B12 is used in the maintenance of myelin sheaths in the nervous system
  • Therefore, deficiency of Vitamin B12 can lead to dysfunction of the nervous system including peripheral nerves and the spinal cord
26
Q

Sickle cell disease genetics

A
  • Single base mutation on the gene responsible for the production of β-globin chain —> replacement of glutamic acid (glutamate) with Valine
  • High altitudes: amount of O2 in the air is reduced —> amount of O2 bound to RBCs is reduced = hypoxemia
  • Abnormal B-globin chains in the Hb molecules within RBC interact with each other and polymerise to form a rigid structure within the cytoplasm —> deformation of the entire cell —> sickle-shaped
  • Sickle shaped cells = unable to pass through the sinusoids in the spleen —> engorged with blood —> stretches capusle —> pain in left upper part of abdomen
27
Q

If haemolysis is the cause of anaemia what type of RBC will be prominent?

A

Increased reticulocyte count

28
Q

Hereditary Spherocytosis

A
  • Caused by a deficiency of Spectrin (membrane protein) —> loss of surface area of RBC membrane —> forces the cell to take on a spherical shape
  • Spherocytes unable to squeeze through the sinus in the spleen —> prematurely trapped and broken down
  • Increased rate of haemolysis can cause jaundice and anaemia
  • Splenomegaly = common feature
29
Q

What nutrients are essential for the production of RBCs (erythropoiesis)?

A

Iron, Vitamin B12 and folate

30
Q

Anaemia occurs when there’s either: (4 things)

A
  • Decreased rate of production of RBCs
  • Increased rate of destruction of RBCs (haemolysis)
  • Loss of RBCs due to blood loss
  • Impaired production of RBC due to a lack of one of the nutrients needed for their production
31
Q

Why are there few reticulocytes in a patient who has leukaemia?

A

All the bone marrow is involved in production of abnormal and useless WBCs —> little space for erythropoiesis —> reticulocyte count is reduced

32
Q

What hormone stimulates production of RBCs? Disease of which organs causes decreased production of this hormone?

A
  • Erythropoietin (EPO)
  • Chronic kidney disease (cause by diabetes for instance)
33
Q

Other cause of a normochromic normocytic anaemia?

A

Renal failure

34
Q

If HGB low and MCV low

A

Microcytic anaemia (iron deficiency)

35
Q

If HGB low and MCV high

A

Macrocytic anaemia (low B12 and folate)

36
Q

If HGB low and MCV normal

A

Normocytic anemia (low EPO)

CP 1080 (4 decks)

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