anaemia

Question 1

why gaviscon -> anarmia

Answer 1

iron best absorbed in acidic env

Question 2

what transports Fe into enterocyte

Answer 2

DMT1

Question 3

what transports Fe from enterocyts into blood

Answer 3

ferroportin

Question 4

what gets the iron off haem

Answer 4

haem oxygenase

Question 5

what carries fe in blood

Answer 5

transferrin

Question 6

which type of Fe can be absorbed ino enterocye

Answer 6

Fe2+

Question 7

who reduces Fe3+ to Fe2+

Answer 7

reductase or anti ox like vit C

Question 8

which enzyme blocks ferroportin

Answer 8

hepcidin

Question 9

where is hepcidin made

Answer 9

liver

Question 10

what Fe ox state is it carried in by transferrin

Answer 10

3+

Question 11

how is iron used in normal cells

Answer 11

mitochondria use it in cytochrome enzyems

Question 12

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

Answer 12

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

Question 13

doctor name for bone marrow

Answer 13

myeloid tissue

Question 14

where does erythropoiesis happen

Answer 14

red bone marrow

Question 15

what happens in yellow bone marrow

Answer 15

lymphopoiesis

Question 16

what controls rate of erythropoiesis

Answer 16

EPO

Question 17

where EPO made

Answer 17

kidneys interstitial cells near proximal tubules

Question 18

what causes ++EPO

Answer 18

low oxygen

Question 19

what does EPO do

Answer 19

increase erythroblast maturation and pro erythroblast formation

Question 20

where foetal erythropoiesis

Answer 20

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

Question 21

how does reticulocyte get out of BM

Answer 21

diapedesis

Question 22

what molecule causes colour of faeces

Answer 22

stercobilin

Question 23

what molecule causes colour of wee

Answer 23

urobilin

Question 24

what is Haem - Fe2+

Answer 24

unconjugated bilirubin

Question 25

where does unconjugated bilirubin go?

Answer 25

liver bound to albumin in the blood

Question 26

what heppens to bilirubin in the liver

Answer 26

gets conjugated with glucoronic acid -> bilirubin diglucoronide

Question 27

how is bilirubin gotten rid of

Answer 27

secreted in bile

Question 28

where is erythrocyte destruction

Answer 28

spleen by macrophages

Question 29

what is glossitis

Answer 29

inlfammation and depapillation of the tongue

Question 30

what is koilonychia

Answer 30

spoon shaped nails

Question 31

what is angular cheilitis

Answer 31

swelling at corners of mouth

Question 32

weird symptom of IDA

Answer 32

pica - eating non-food such as dirt or ice

Question 33

name 5 tests for IDA

Answer 33

Question 34

IDA in older adult or younger with no obvious apparent cause

Answer 34

CHECK FOR GI MALIGNANCY

Question 35

what does haptoglobin do

Answer 35

mop up free haemoglobin in the blood

Question 36

haemolytic anaemia divided into

Answer 36

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

Question 37

DAT - haemoglobinopathy example

Answer 37

sickle cell

Question 38

is sickle cell DAT+

Answer 38

no

Question 39

infection that can cause haemolytic anaemia

Answer 39

malaria clostridium

Question 40

how does acute haemolytic anaemia present?

Answer 40

pt is bright yellow

Question 41

why is patient bright yellow

Answer 41

too much conjugated bilirubin

Question 42

what testresults in acute haemolytic anaemia

Answer 42

haemoglobinuria haemoglobinaemia

Question 43

risk factor for caridac arrest in acute haemolytic anaemia

Answer 43

acute hyperkalemia

Question 44

jaundice, splenomegally and pigment gallstones are signs of

Answer 44

acute haemolytic anaemia

Question 45

what is alloimmune haemolytic anaemia

Answer 45

you develop antibodies to transfused blood Or neonatal - mum's antibodies start to haemolyse baby blood

Question 46

3 problem areas in RBC that can lead to haemolytic anaemia

Answer 46

enzymes membrane haemoglobin misspelling

Question 47

what is intravascular haemolytic anaemia

Answer 47

Question 48

what is extravascular haemolytic anaemia

Answer 48

Question 49

why splenomegaly in what is intravascular haemolytic anaemia

Answer 49

extramedullary haematopeosis - making rbc in red pulp of spleen

Question 50

which membrane proteins can go wrong to cause hereditary spherocytosis

Answer 50

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

Question 51

hereditary spherocytosis mode of inheritance

Answer 51

AD

Question 52

what is this common inherited maemolytic anaemia

Answer 52

spherocytosis

Question 53

why pt urine normal in day and black at night

Answer 53

Paroxysmal nocturnal haemoglobinuria

Question 54

what is cause of Paroxysmal nocturnal haemoglobinuria

Answer 54

problem with RHAG complement mediated

Question 55

what is tx for Paroxysmal nocturnal haemoglobinuria? Moa?

Answer 55

eculizumab - binds C5 protein so can't be activated

Question 56

sickle cell mutation

Answer 56

point - glu is now val

Question 57

reticulocyte count in sickle

Answer 57

3-4-500

Question 58

sickle hallmarks

Answer 58

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

Question 59

most common enzymopathy

Answer 59

G6PD

Question 60

meds to avoid in G6PD

Answer 60

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

Question 61

G6PD mode of inheritance

Answer 61

X linked but female pts are seen

Question 62

Answer 62

G6PD