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Anaemia Flashcards

1
Q

Define anaemia

A

Anaemia is a lower than normal concentration of haemoglobin or red blood cells (Hb <130 in men, <120 women)

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2
Q

name the 5 different types of anaemia

A

Haemolytic: increased breakdown of RBC’s
Aplastic: decreased RBC, WC, platelets
Microcytic: reduced MCV
Macrocytic: raised MCV
Normocytic: normal MCV

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3
Q

most common cause of anaemia

A

Fe deficiency

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4
Q

symptoms of anaemia

A

Symptoms: fatigue, headache, dizziness, dyspnoea (especially on exertion)

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5
Q

signs of anaemia

A

Signs: tachycardia, pale skin , conjunctiva painless , intermittent claudication

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6
Q

presentation of anaemia

A

tired
cold
palpitations

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7
Q

What may specifically indicate haemolytic anaemia

A

jaundice or dark urine

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8
Q

what may specifically indicate b12 deficiency

A

lemon- yellow skin
angular stomatis - skin condition

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9
Q

what causes b12 deficiency

A

pernicious anaemia
loss of intrinsic factor production

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10
Q

what may specifically indicate iron deficiney

A

angular stomatis or koilonychia - spoon shaped nails

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11
Q

What is mcv

A

mean corpuscular volume

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12
Q

5 causes of microcytic anaemia

A

T- Thalassaemia
A- Anaemia of chronic disease
I-Iron deficiency
L-Lead poisoning
S-Sideroblastic Anaemia

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13
Q

what is thalassaema

A

defect in the production of alpha or beta chains in hb

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14
Q

What would a full blood count for Microcytic anaemia show

A

low hb
mcv <80

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15
Q

what would a blood film show for microcytic anaemia

A

small hypochromic cells

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16
Q

In iron deficiency microcytic anaemia what would iron studies show

A

Low ferratin (unless active inflammation)
Low serum iron
Low transferrin saturation
Raised transferrin

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17
Q

what is the role of ferratin

A

Ferratin = main protein that stores iron intracellularly. Predominantly in the liver. Ferratin is an acute phase reactant so will rise in acute inflammation.

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18
Q

why would transferrin be raised in anaemia

A

body tries to compensate for reduced iron levels by producing more transferrin.

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19
Q

what is the role of transferrin

A

protein mediating iron transport in the blood

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20
Q

most common cause of FE deficiency anaemia

A
  • blood loss as most common
    -malnutrition - kids
  • poor iron absorption
    elderly 60+ RARE RED FLGAG, colon cancer or bleeding
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21
Q

treatment for fe deficiency anaemia

A

oral iron - ferrous sulfate

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22
Q

SE of ferrous sulfate

A

nausea, abdo discomfort, diarrhoea, constipation

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23
Q

causes of chronic microcytic anaemia

A

Chronic infection
Chronic inflammation (connective tissue diseases)
Neoplasia

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24
Q

pathogenesis of microcytic chronic anaemia

A
  • inflammatory cytokines lead to reduced sensitivity of the marrow to epo and failure to incorporate iron into developing cells
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25
what is sideroblastic anaemia
iron levels are normal but the body cant insert this into hb
26
what type of anaemia are alpha and beta thalassaemia
microcytic
27
what causes alpha thalassaemia
due to insufficient synthesis of alpha-hemoglobin chains and an excess of beta chains. - 4 genes on alpha chain, 2 from each parent
28
symptoms of b thalassaemia
CHIPMUNK FACE hepatospenomegaly massively enlarged forehead + cheekbones due to decrease in RBC
29
DIAGNOSIS for b thalassaemia
FBC+ blood film- hypochromic RBC HB electrophoresis
30
pathophysiology of b thalassaemia
- decreased or no b chain production - excess a chain
31
Treatment of B thalassaemia
- regular transfusion, iron chelation
32
mcv value for normocytic anaemia
80-95mcv
33
causes of normocytic anaemia
anaemia of chronic disease chronic kidney disease aplastic anaemia haemolytic anaemia acute blood loss
34
normoblastic causes of macrocytic anaemia
alcohol liver disease hypothyroidism pregnancy reticulocytosis myelodysplasia drugs
35
megaloblastic causes of macrocytic anaemia
b12 deficiency folate deficiency
36
what is sickle cell anaemia
a genetic condition that causes sickle shapes red blood cells - normocytic
37
pathophysiology of sickle cell anaemia
Hbf is usually replaced with Hba around 6 weeks after birth in SCA it is replaced with an abnormal variant HbS
38
main issue with sickle cell anaemia
hbS polymerises when deoxygenated
39
CAUSE of sickle cell
single point mutation in b globin gene - HbS
40
Describe the genetic background of SCA
AUTOSOMAL RECESSIVE abnormal gene for beta-globin on chromosome 11 one copy results in the trait.
41
Link between malaria and SCA
SCA more prevalent in areas where malaria is also common, having one copy reduces the severity of malaria
42
acute presentation of SCA
MSK: Bone pain, joint pain Infection Resp: dyspnoea, cough, hypoxia CNS: stroke GI: sequestration crisis
43
WHAT IS SEQUESTRATION CRISIS
blood outflow from the spleen is blocked. Blood accumulates - splenomegaly
44
diagnosis of SCA ?
- newborn screening - heel prick test -sickle solubility -blood film + fbc, normocytic normochromic with increased reticulocytes and howell jolly bodies -HB electrophoresis
45
MANAGEMENT OF SCA
- avoid dehydration and other triggers -ensure vaccines are up to date -antibiotic prophylaxis -blood transfusion for severe anaemia
46
treatment for acute complicated attacks of SCA
iv fluids ANALGESIA o2
47
what is G6PDH DEFIEICNY
condition where there is a defect in the red blood cell enzyme G6PD
48
what is the presentation of g6pd deficiency
jaundice- in neonates gall stones anaemia Heinz bodies on blood film
49
what does g6pd cause
crises that are triggered by infections medications or fava beans
50
to diagnose g6pd deficiency
FBC AND BLOOD FILM- heinz bodies decrease in G6PDH LEVELS
51
TREATMENT FOR G6PD
avoid triggers and precipitans
52
what is hereditary spherocytosis
a deficiency in structural membrane protein spectrin-- increase in splenic recycling
53
what does Hereditary spherocytosis cause
spenomegaly
54
sx of hereditary spherocytosis
general anaemia, neonatal jaundice , splenomegaly, gall stones
55
treatment of hereditary spherocytosis
splenectomy and folate supplementation
56
what is autoimmune haemolytic anaemia
when antibodies are created against the patients red blood cells leads to destruction on ones own RBC
57
two types of autoimmune haemolytic anaemis
warm cold
58
is warm or cold more common
warm
59
describe warm type autoimmune haemolytic anaemia
occurs at normal or above normal temperatures usually idiopathic
60
describe cold type autoimmune haemolytic anaemia
also called cold agglutin disease at lower temperatures the antibodies against red blood cells attach themselves to RBC anc clump together agglutination-
61
management of autoimmue haemolytic anaemia
blood transfusions prednisolone rituximab splenctomy
62
what issues are associated with microcytic anaemia
iron deficiency thalassaemias
63
what issues are associated with normocytic anaemia
chronic disease renal disease acute bleeding
64
what issues are assocaited with macrocytic anaemia
folate deficiency b12 deficiency
65
how much iron does a regular adult need and how much is absorbed
15mg a day only 1mg is absorbed
66
presentation of anaemia
tired cold palpitations
67
How can kidney disease cause decrease in RBC production
Epo is made in the kidney so less epo then less erythropoiesis
68
Intravascular haemolysis causes
mismatched blood transfusion G6PD deficiency* red cell fragmentation: heart valves, TTP, DIC, HUS paroxysmal nocturnal haemoglobinuria cold autoimmune haemolytic anaemia
69
Extravascular haemolysis causes
haemoglobinopathies: sickle cell, thalassaemia hereditary spherocytosis haemolytic disease of newborn warm autoimmune haemolytic anaemia
70
Blood film for thalassaemia would show ?
Heinz bodies Target cells Basophiloic stippling
71
Bleeding problems, normal platelets, raised bleeding time, slightly raised APTT in a question is most likely to indicate:
Von willerbrand disease
72
10-year-old child with a history of neonatal jaundice develops pallor and jaundice after an upper respiratory tract infection associated with erythematous cheeks. Splenomegaly is noted on examination is a stereotypical history of:
Hereditary spherocytosis
73
Presentation of hereditary spherocytsis
failure to thrive jaundice, gallstones splenomegaly aplastic crisis precipitated by parvovirus infection degree of haemolysis variable MCHC elevated

Haemotology (7 decks)

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