Anaemia

Question 1

What is anaemia?

Answer 1

Low level of haemoglobin in the blood as a result of an underlying disease

Question 2

As well as Hb levels, what other component of a blood test should be looked at in a patient that has anaemia?

Answer 2

Mean cell volume

Question 3

Name 3 causes of a microcytic anaemia (TAILS)

Answer 3

T – Thalassaemia
A – Anaemia of chronic disease
I – Iron deficiency anaemia
L – Lead poisoning
S – Sideroblastic anaemia (body produces enough iron but is unable to store it in Hb)

Question 4

Name 3 causes of a normocytic anaemia (3As and 2Hs)

Answer 4

A – Acute blood loss
A – Anaemia of Chronic Disease
A – Aplastic Anaemia (body stops producing enough new RBCs) + other causes of bone marrow failure i.e. myelodysplasia
H – Haemolytic Anaemia
H – Hypothyroidism

Question 5

What are the 2 subcategories of macrocytic anaemia?

Answer 5

Megaloblastic and normoblastic

Question 6

1) What is the pathophysiology of a megaloblastic anaemia?
2) What are the 2 main causes?

Answer 6

1) Impaired DNA synthesis prevents the cell from dividing normally - rather than dividing it keeps growing into a larger, abnormal cell. This is caused by a vitamin deficiency
2) Vit B12 and folate deficiency

Question 7

Name 2 causes of a normoblastic macrocytic anaemia

Answer 7

• Alcohol
• Reticulocytosis (usually from haemolytic anaemia or blood loss)
• Hypothyroidism
• Liver disease
• Drugs i.e. azathioprine

Question 8

Name 3 symptoms of anaemia

Answer 8

• Tiredness
• Shortness of breath
• Headaches
• Dizziness
• Palpitations
• Worsening of other conditions i.e. angina, HF, peripheral vascular disease

Question 9

Name 2 generic signs of anaemia

Answer 9

• Pale skin
• Conjunctival pallor
• Tachycardia
• Raised respiratory rate

Question 10

1) What type of anaemia does koilonychia indicate?
2) What type of anaemia does angular chelitis indicate?
3) What type of anaemia does atrophic glossitis indicate?
4) What type of anaemia does brittle hair and nails indicate?
5) What type of anaemia does jaundice indicate
6) What type of anaemia does brittle bones indicate?

Answer 10

1) Iron deficiency
2) Iron deficiency
3) Iron deficiency
4) Iron deficiency
5) Haemolytic
6) Thalassaemia

Question 11

Name 4 investigations for anaemia

Answer 11

• Haemoglobin
• Mean Cell Volume (MCV)
• B12
• Folate
• Ferritin
• Blood film
• Oesophago-gastroduodenoscopy (OGD) and colonoscopy (look for cause of iron def.)
• Bone marrow biopsy

Question 12

What cancer does pernicious anaemia predispose to?

Answer 12

Gastric cancer