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YR 5 pathology > Anaemia > Flashcards

Anaemia Flashcards

1
Q

Hb levels for anaemia (males and females)

A

males (<135g/L)
females (<115g/L)
severe = <80g/L

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2
Q

Types of anaemia

A

microcytic (small MCV)
normacytic
macrocytic (large MCV)

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3
Q

symptoms of anaemia

A

fatigue
dyspnoea
faintness
palpitations
headache
tinitus/anorexia

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4
Q

signs of anaemia

A

pallor
severe (<80g/L) => hyperdynamic circulation => HF
- tachycardia
- ejection systolic mumur

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5
Q

causes of microcytic anaemia

A

Fe deficiency
Anaemia of chronic disease (cytokine driven inhibition of RBC production)
Sideroblastic anaemia (ineffective RBC production => iron loading in bone marrow)
Sickle cell
Thalassemia

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6
Q

causes of iron deficiency anaemia

A

blood loss (GI bleeding)
increased usage (pregnancy/lactation)
reduced intake (vegan/vegetarian)
reduced absorption (bariatric surgery, coeliac disease)

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7
Q

causes of GI bleeding => anaemia

A

Meckels diverticulum (older child)
menorrhagia (women <50)
colorectal cancer/ polyps (>50)
peptic ulcer disease/ gastritis (chronic NSAID use)
hookworm (developing countries)

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8
Q

signs of iron deficiency anaemia

A

angular cheliosis - blistering around mouth
koilonychia - spoon nails
atrophic glossitis - smooth tongue
brittle hair + nails
post-cricoid webs (Plummer- Vinson syndrome)

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9
Q

why are blood transfusions better for patients with anaemia and sepsis

A

iron won’t absorb well and can worsen sepsis so give transfusions

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10
Q

causes of anaemia of chronic disease

A

chronic infection (TB, osteomyelitis)
vasculitis
RA
malignancy

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11
Q

why is ferritin (store of iron) high in anaemic of chronic disease

A

stored in macrophages so invading bacteria can’t use it

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12
Q

causes of sideroblastic anaemia

A

myelodysplastic disorders
chemotherapy/ irradiation
alcohol excess
anti-TB
myeloproliferative disorders

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13
Q

causes of normacytic anaemia

A

blood loss
haemolytic anaemia (destruction of RBCs)
bone marrow failure
renal failure
primary myelofibrosis (BM cancer)

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14
Q

types of haemolytic anaemia

A

congenital
- GP6D deficiency
- hereditary spherocytosis

acquired
- autoimmune
- microangiopathic haemolytic anaemia (MAHA)

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15
Q

Causes of megaloblastic macrocytic anaemia

A

B12 deficincy
folate deficiency
cytotoxic drugs

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16
Q

Causes of non-megaloblastic anaemia

A

alcohol
reticulocytosis
liver disease
hyperthyroidism
pregnancy

17
Q

how to differentiate between autoimmune and MAHA

A

autoimmune is direct antiglobulin test (DAT)/ COOMBs positive

18
Q

How does COOMBs test work

A

detects antibodies stuck to surface of RBCs
- direct/indirect test

19
Q

Types of MAHA

A

Haemolytic uraemic syndrome (HUS)
Thrombotic thrombocytopenic purpura (HUS + CNS signs/ fever)
Disseminated intravascular coagulation (DIC)

20
Q

Symptoms of HUS

A

AKI
Thrombocytopenia (XS bleeding)
jaundice

21
Q

which type of MAHA will a kid with E.coli infection get?

A

HUS

22
Q

what is DIC

A

depletion of clotting factors due to overactivation of clotting cascade from infection/cancer

23
Q

Types of DIC

A

acute - more bleeding (petechiae, purpura, ecchymoses)
chronic - slower more clotting (DVT/ arterial thrombosis)

24
Q

How to diagnose DIC

A

FBC - low platelets
clotting profile - low fibrinogen, high fibrin degradation products
blood film - schistocytes

25
Q

How does renal failure cause anaemia

A

reduced EPO secretion so bone marrow makes less RBCs

26
Q

Causes of megaloblastic macrocytic anaemia

A

B12 deficiency
folate deficiency
antifolates
reticulocytosis
myelodysplastic syndromes

27
Q

types of antifolate drugs

A

methotrexate
trimethoprim

28
Q

what is myelodysplastic syndrome

A

group of cancers where immature blood cells in bone marrow don’t mature

29
Q

initial investigations for anaemia

A

FBC (low RBC, low Hb, MCV)
U&Es (low EPO)
LFTs (liver problems/ alcoholics high GGT)
TFTs (hypothyrodism)
iron levels
B12/folate levels
clotting profile

30
Q

investigations for iron deficiency anaemia

A

blood tests (iron studies)
if no obvious cause
- OGD +/- colonoscopy
- urine dip (loss of Hb in urine)
- anti-TTG (coeliac disease)

31
Q

Special investigations for anaemia

A

blood film
- microcytic, hypochromic => iron deficiency
- megaloblasts => megalobasltic macrocytic anaemia
- schistocytes => DIC

32
Q

How to diagnose sideroblastic anaemia

A

ring sideroblasts in the bone marrow on blood film (iron deposits around mitochondria like a ring)

33
Q

management of anaemia

A

treat cause

oral ferrous sulphate
B12/folate supplements

SEVERE/SEPSIS => blood transfusions
bone marrow/stem cell transplants

34
Q

treatment of iron deficiency anaemia

A

TREAT CAUSE
1. oral iron
2. severe anaemia => IV iron

35
Q

treatment for sideroblastic anaemia

A

remove cause
give pyridoxine (vitamin B6 promotes RBC production)

YR 5 pathology (9 decks)

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