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Year 2 CR > anaemia > Flashcards

anaemia Flashcards

1
Q

why gaviscon -> anarmia

A

iron best absorbed in acidic env

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2
Q

what transports Fe into enterocyte

A

DMT1

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3
Q

what transports Fe from enterocyts into blood

A

ferroportin

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4
Q

what gets the iron off haem

A

haem oxygenase

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5
Q

what carries fe in blood

A

transferrin

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6
Q

which type of Fe can be absorbed ino enterocye

A

Fe2+

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7
Q

who reduces Fe3+ to Fe2+

A

reductase or anti ox like vit C

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8
Q

which enzyme blocks ferroportin

A

hepcidin

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9
Q

where is hepcidin made

A

liver

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10
Q

what Fe ox state is it carried in by transferrin

A

3+

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11
Q

how is iron used in normal cells

A

mitochondria use it in cytochrome enzyems

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12
Q

liver releases ferritin in acute inflammation. what does this mean?

A

in eg RA, serum ferritin can be high even in anaemia

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13
Q

doctor name for bone marrow

A

myeloid tissue

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14
Q

where does erythropoiesis happen

A

red bone marrow

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15
Q

what happens in yellow bone marrow

A

lymphopoiesis

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16
Q

what controls rate of erythropoiesis

A

EPO

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17
Q

where EPO made

A

kidneys interstitial cells near proximal tubules

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18
Q

what causes ++EPO

A

low oxygen

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19
Q

what does EPO do

A

increase erythroblast maturation and pro erythroblast formation

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20
Q

where foetal erythropoiesis

A

You - yolk sac 3-8 wks
Like - Liver 6wk - birth
Split - spleen 8-28 wk
Bonanas - bone marrow18wk to adult

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21
Q

how does reticulocyte get out of BM

A

diapedesis

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22
Q

what molecule causes colour of faeces

A

stercobilin

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23
Q

what molecule causes colour of wee

A

urobilin

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24
Q

what is Haem - Fe2+

A

unconjugated bilirubin

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25
Q

where does unconjugated bilirubin go?

A

liver bound to albumin in the blood

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26
Q

what heppens to bilirubin in the liver

A

gets conjugated with glucoronic acid -> bilirubin diglucoronide

27
Q

how is bilirubin gotten rid of

A

secreted in bile

28
Q

where is erythrocyte destruction

A

spleen by macrophages

29
Q

what is glossitis

A

inlfammation and depapillation of the tongue

30
Q

what is koilonychia

A

spoon shaped nails

31
Q

what is angular cheilitis

A

swelling at corners of mouth

32
Q

weird symptom of IDA

A

pica - eating non-food such as dirt or ice

33
Q

name 5 tests for IDA

A
34
Q

IDA in older adult or younger with no obvious apparent cause

A

CHECK FOR GI MALIGNANCY

35
Q

what does haptoglobin do

A

mop up free haemoglobin in the blood

36
Q

haemolytic anaemia divided into

A

DAT +
DAT-

DAT + indicates the presence of immunoglobulin (Ig)G, IgM, IgA or complement (usually C3d) bound to the red cell membrane so basically very likely to be autoimmune condition

DAT - haemoglobinopathies membranopathies
infections

37
Q

DAT - haemoglobinopathy example

A

sickle cell

38
Q

is sickle cell DAT+

A

no

39
Q

infection that can cause haemolytic anaemia

A

malaria
clostridium

40
Q

how does acute haemolytic anaemia present?

A

pt is bright yellow

41
Q

why is patient bright yellow

A

too much conjugated bilirubin

42
Q

what testresults in acute haemolytic anaemia

A

haemoglobinuria
haemoglobinaemia

43
Q

risk factor for caridac arrest in acute haemolytic anaemia

A

acute hyperkalemia

44
Q

jaundice, splenomegally and pigment gallstones are signs of

A

acute haemolytic anaemia

45
Q

what is alloimmune haemolytic anaemia

A

you develop antibodies to transfused blood

Or neonatal - mum’s antibodies start to haemolyse baby blood

46
Q

3 problem areas in RBC that can lead to haemolytic anaemia

A

enzymes
membrane
haemoglobin misspelling

47
Q

what is intravascular haemolytic anaemia

A
48
Q

what is extravascular haemolytic anaemia

A
49
Q

why splenomegaly in what is intravascular haemolytic anaemia

A

extramedullary haematopeosis - making rbc in red pulp of spleen

50
Q

which membrane proteins can go wrong to cause hereditary spherocytosis

A

Heterogeneous – deficiencies of spectrin (41.5%), ankyrin (1.5%), band 3 (17%), band 4.2 (21.5%)

51
Q

hereditary spherocytosis mode of inheritance

A

AD

52
Q

what is this common inherited maemolytic anaemia

A

spherocytosis

53
Q

why pt urine normal in day and black at night

A

Paroxysmal nocturnal haemoglobinuria

54
Q

what is cause of Paroxysmal nocturnal haemoglobinuria

A

problem with RHAG
complement mediated

55
Q

what is tx for Paroxysmal nocturnal haemoglobinuria? Moa?

A

eculizumab - binds C5 protein so can’t be activated

56
Q

sickle cell mutation

A

point - glu is now val

57
Q

reticulocyte count in sickle

A

3-4-500

58
Q

sickle hallmarks

A

ischaemia
shortened rbc lifespan
++inflammation
could be pyrexia
vasoocclusion
infection
stroke in children

59
Q

most common enzymopathy

A

G6PD

60
Q

meds to avoid in G6PD

A

Dapsone. Methylene blue. Nitrofurantoin. Pegloticase. Phenazopyridine. Primaquine. Rasburicase. Tafenoquine.
Chemicals to avoid. Naphthalene (an ingredient found in moth balls)

61
Q

G6PD mode of inheritance

A

X linked but female pts are seen

62
Q
A

G6PD

63
Q
A

Year 2 CR (33 decks)

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