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2.2 Haematology > Anaemia > Flashcards

Anaemia Flashcards

1
Q

What is anaemia
(3)

A

A decrease in the competence of blood to carry oxygen to tissues, thereby causing tissue hypoxia

It is not a disease but the expression of an underlying disorder or disease -> once anaemia is diagnosed the cause must be determined

Defined clinically when Hb concentration is below the accepted range

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2
Q

What group of individuals may have a high haemoglobin

A

Babies

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3
Q

What is the average haemoglobin for an adult female

A

140

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4
Q

What is the average haemoglobin for an adult male

A

155

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5
Q

List the signs of anaemia
(5)

A

Pallor
Tachycardia
Glossitis
Koilonychia
Dark urine

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6
Q

What is tachycardia

A

Pulse rate over 100 beats per minute

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7
Q

What is glossitis

A

Swollen and painful tongue due to vitamin B12 deficiency

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8
Q

What is koilonychia

A

Spoon nails -> seen in iron deficiency

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9
Q

What type of anaemia is dark urine seen in?

A

Haemolytic anaemia

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10
Q

What are the symptoms of anaemia
(6)

A

Decreased work capacity
Fatigue, lethargy
Weakness
Dizziness
Palpitations
Shortness of breath

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11
Q

What are the symptoms of severe anaemia
(7)

A

Jaundice
Splenomegaly
Hepatomegaly
Angina
Cardiac failure
Fever
Fainting

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12
Q

What is meant by “adaptations” to anaemia
(2)

A

A healthy person can lose up to 1 litre or 20% of blood and not have any symptoms except mild tachycardia during exercise

Therefore if you gradually develop a dietary anaemia your body will make adjustments for the anaemia -> body will get used to this e.g. in pregnant women -> they might not feel it until haemoglobin is very low

e.g. body might increase blood flow

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13
Q

How much blood can a person lose

A

Severe blood loss is considered between 1.5 and 2L (30-40% of blood) -> leads to circulatory collapse and shock

If 50% of blood is lost then death is imminent

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14
Q

Give some examples of how the body adapts to anaemia

A

Increase in oxygenated blood flow

Increase in oxygen utilisation by tissues

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15
Q

How does the body increase oxygenated blood flow
(4)

A

Increase cardiac rate
Increase cardiac output
Increase circulation rate
Preferential increase in blood flow to vital organs

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16
Q

How does the body increase oxygen utilisation by tissues

A

Increases 2,3-DPG in erythrocytes
2,3-DPG forces haemoglobin to release oxygen

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17
Q

Anaemia is classified by the causes, list these categories
(6)

A

Bone marrow

Problems with iron

Lack of vitamins

Anaemia associated with disease in other organs

Haemolysis

Anaemia arising from a gene mutation

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18
Q

What two things result in bone marrow caused anaemia

A

Suppression

Infiltration

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19
Q

What three things involving iron cause anaemia

A

Deficiency at the bone marrow

Excess absorption

Ineffective incorporation into haem

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20
Q

Anaemia can be associated with what organs

A

Liver
Kidney
Reproductive organs
Connective tissues
Thyroid

21
Q

Anaemia can be caused by haemolysis under what conditions?

A

Due to antibiotics

Due to drugs

Due to infections

22
Q

Anaemia can rise from what genetic mutations

A

Haemoglobinopathies
Membrane defects
Enzyme defects

23
Q

In general what are the three causes of anaemia

A

Decreased production of red cells -> due to marrow failure

Increased destruction of rbcs -> haemolysis

Loss of red cells due to bleeding -> acute/chronic blood loss

24
Q

What are the two ways to classify anaemias

A

On the basis of cause

On the basis of morphology

25
Q

How are anaemias classified on the basis of morphology
(3)

A

Normocytic

Microcytic

Macrocytic

26
Q

What information can you find from the full blood count
(9)

A

Amount of haemoglobin the the blood

Number of rbcs

% of rbcs as a proportion of the total blood volume (Haematocrit)

Average volume of rbcs (MCV)

Average concentration of Hb in the RBC (MCBH)

Average concentration of Hb in the RBC volume (MCHC)

Number of wbcs

% of the different types of WBCs

Number of platelets

27
Q

What does MCV let us know?

A

If the rbcs are microcytic, normocytic or macrocytic

28
Q

What are the causes of microcytic anaemia
(4)

A

Iron deficiency

Chronic disease (Renal Failure)

Haemoglobinopathies (Thalassemias)

Sideroblastic Anaemia

29
Q

What can cause normocytic cells in anaemia
(5)

A

Acute bleeds

Chronic disease

Early iron deficiency anaemia

Bone marrow disorders

Haemolytic Anaemias

30
Q

What can cause macrocytic rbcs in anaemia
(5)

A

Megaloblastic anaemias

Liver disease/alcohol

Metabolic disorders

Bone marrow disorders

Haemolytic anaemias

31
Q

What does red cell distribution width measure

A

Anisocytosis

32
Q

Anisocytosis is often seen in what types of anaemia

A

Thalassaemias and anaemia of chronic disorder

33
Q

What does a patient with a low MCV and high RDW have

A

Iron deficiency anaemia

34
Q

What does a normal RDW and a low MCV suggest

A

Thalassaemia or an anaemia of chronic disorder

34
Q

What does a normal RDW and a low MCV suggest

A

Thalassaemia or an anaemia of chronic disorder

35
Q

What does a normal RDW and a low MCV suggest

A

Thalassaemia or an anaemia of chronic disorder

36
Q

What occurs in hypoproliferative bone marrow
(4)

A

Decreased reticulocytes

The bone marrow is unable to produce requisite number of RBCs

Lack of essential substances to make rbcs such as iron, B12 or folate

Lack of essential substance due to the invasion of the marrow by a disease process such as leukaemia or aplastic anaemia

37
Q

What happens in hyperproliferative bone marrow
(4)

A

Increased reticulocytes

Cause of anaemia outside the marrow e.g. haemolytic anaemia, or haemorrhage

Decreased survival of the rbcs

Marrow normal and responds adequately by increasing the output

38
Q

What is the % reticulocyte count

A

The total number of reticulocytes seen in 1000 red cells

39
Q

What might increase % reticulocyte count
(2)

A

An increase in the number of reticulocytes in circulation

A decrease in the rbc count

40
Q

What is the absolute reticulocyte count
(2)

A

A more accurate reticulocyte count used to diagnose anaemia

A more informative index of erythropoietic activity as it takes into account the red cell count

41
Q

What is the equation for an absolute reticulocyte count

A

RBC x % retic count (50-100 x 10^9/L)

42
Q

What happens to retic count and RDW in iron deficiency

A

Retic count often decreased

RDW may be high

43
Q

What happens to retic count and RDW in thalassemia

A

Reticulocyte count often elevated

RDW may be normal

44
Q

What happens to retic count and RDW in chronic disease

A

Retic count often decreased

RDW may be normal

45
Q

What is anisocytosis

A

Different sizes of RBC

46
Q

What is poikilocytosis

A

Different shapes of RBCs

47
Q

Target cells are seen in what disorders
(5)

A

Iron deficiency

Liver disease

Thalassemia

HbC/D Disease

Post splenectomy

2.2 Haematology (38 decks)

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