Anaemia

Question 1

Causes of microcytic anaemia

Answer 1

Iron deficiency
Anaemia of chronic disease (can also be normocytic)
Sideroblastic anaemia
Thalassaemia

Question 2

Iron study findings in iron deficiency

Answer 2

Serum iron - low
%saturation of transferrin - low
Ferritin - low
Total iron binding capacity - high

Question 3

Iron study findings in anaemia of chronic disease

Answer 3

Serum iron - low
%saturation - low
Ferritin - high (hepcidin sequesters iron in liver)
TIBC - low

Question 4

Causes of normocytic anaemia

Answer 4

Anaemia of chronic disease (can be normocytic)
Haemolytic anaemia

Question 5

In haemolytic anaemia, what will the reticulocyte count be?

Answer 5

Raised

Question 6

What causes megaloblastic haemolytic anaemia?

Answer 6

Anything causing impaired DNA synthesis:
Folate/B12 deficiency

Question 7

What drug can cause megaloblastic anaemia and why?

Answer 7

Methotrexate
Folate antagonist

Question 8

What is pernicious anaemia?

Answer 8

Autoimmune destruction of gastric parietal cells, leading to lack of intrinsic factor so B12 not absorbed

Question 9

Causes of non-megaloblastic macrocytic anaemia?

Answer 9

Alcoholism
Hypothyroidism
Reticulocytosis
Drugs (fluorouracil)
Pregnancy

Question 10

What else can be seen on blood film in megaloblastic anaemia?

Answer 10

Hypersegmented neutrophils

Question 11

What haemoglobin is the blood transfusion threshold?

Answer 11

70g/l

Question 12

What haemoglobin is the blood transfusion threshold in patients with ACS?

Answer 12

80g/l

Question 13

Haemochromatosis iron studies findings

Answer 13

Transferrin saturations >45%
Elevated ferritin