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Y2 HIT (Fri) > Anaemia > Flashcards

Anaemia Flashcards

1
Q

What is the normal Hb range?

A

115g/l for women
130g/l for males

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2
Q

spherocytosis
(Hereditary spherocytosis) (HS):

A

defect of the RBC membrane
hereditary
RBCs are rounded and spherical
- most common in Northern Europe​

– mutation = malfunctional proteins that cause interactions between the cytoskeleton and lipid bilayer of the red cell
– lipid bilayer of RBC membrane unsupported by cytoskeleton
– cells become spherical

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3
Q

elliptocytosis

A

defect of the RBC membrane
hereditary disorder
RBCs appear oval

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4
Q

thalassaemia

A

Defect of haemoglobin production – too little made
- defunct production of α and β globin chains
- mainly affects people of Mediterranean, south Asian, southeast Asian and Middle Eastern origin

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5
Q

Oxyhaemoglobin

A

haemoglobin bound to oxygen​

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6
Q

where does oxygen loading take place?

A

in the lungs

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7
Q

Deoxyhaemoglobin

A

haemoglobin after oxygen has diffused into tissues
(reduced Hb)

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8
Q

Carbaminohaemoglobin

A

haemoglobin bound to carbon dioxide

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9
Q

where does carbon dioxide loading take place?

A

in the tissues

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10
Q

Transferrin

A

glycoprotein which transports iron and binds to transferrin receptors on certain immature RBCs
creates a transferrin/receptor complex

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11
Q

where does iron absorption occur?

A

mostly in duodenum

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12
Q

How does lifestyle have an effect on anemia diagnosis?

A

Not as much energy output – higher Hb not needed ​
Not classed as aneamic

Smaller person will have less heamoglobin and lower BCC than a bigger person

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13
Q

what is the rule of anaemia diagnosis if the patient doesn’t exhibit any symptoms?

A

no symptoms = no diagnosis, no disease

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14
Q

what does MCV measure and how is it used as an indicator of anaemia?

A

measures the size of red blood cells

It classifies anaemias based on size:
Microcytic (small) MCV <77fl​
Normocytic (normal) MCV 78-99fl​
Macrocytic (big) MCV >100fl​

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15
Q

what is the reference range of MCV?

A

80-99fl

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16
Q

Microcytic anaemia

A

MCV <77fl​ (small RBCs)

17
Q

Normocytic anaemia

A

MCV 78-99fl​ (normal sized RBCs)

18
Q

Macrocytic anaemia

A

MCV >100fl​ (Large RBCs)

19
Q

hypochromia

A

RBCs exhibit less colour on blood film
due to less haemaglobin = less red pigment

20
Q

rank the most likely causes of anaemia

A

iron deficiency anaemia​

Thalassaemia

General haemoglobin defects​

Metal poisoning (lead, aluminium)​

21
Q

causes of iron deficiency anaemia

A

poor diet​ - most common

Blood loss (GI, menorrhagia)​

Increased demand (pregnancy, growth)​

Dialysis​

Hookworm infestation​

Haemoglobinuria (paroxysmal nocturnal, bladder cancer)​

Epistaxis​

22
Q

3 stages of iron deficiency anaemia

A

Prelatent
​– Reduction in iron stores without reduced serum iron levels​

Hb (N)
MCV (N)
iron absorption (incr.), transferrin saturation (N),
serum ferritin (Decr.),
marrow iron (Decr.)​

Latent​
– Iron stores are exhausted, but the blood haemoglobin level remains normal​

Hb (N),
MCV (N),
serum ferritin (Decr.),
transferrin saturation (Decr.), marrow iron (absent)​
​

Iron Deficiency Anemia​
– Blood haemoglobin concentration falls below the lower limit of normal​

Hb (Decr),
MCV (Decr),
serum ferritin (Decr),
transferrin saturation (Decr),
marrow iron (absent)​

23
Q

How would Iron Deficiency anaemia show on a blood film?

A

Target cells​

Hypochromia​ - less pigment and larger white centre

Microcytes​ - small

Anisopoikilocytosis​:
combination of
- anisocytosis - irregular size
- poikilocytosis - irregular shape

24
Q

How can you identify iron deficiency anaemia through blood tests?

A
  • Blood film – irregular size, shape and colour. Target cells present
  • Low serum iron and ferritin (biochemistry)​
  • Red cell indices fall in proportion to severity, platelet count can rise​
25
Q

what is likely causing Normocytic Anaemia​?

A

Acute blood loss​

Hereditary spherocytosis (this lecture)​

Haemolytic anaemias​

Auto immune disease​

Sickle cell (next lecture)​

Anaemia of Chronic Disease (Cancer, kidney disease, renal failure, rheumatoid arthritis)​

26
Q

what are some unlikely, rare causes of Normocytic Anaemia?

A

South East Asian ovalocytosis​

Paroxysmal nocturnal haemoglobinuria​

G6PD deficiency​

27
Q

Causes of B12 deficiency:​

A

Inadequate diet (vegans need Marmite)​

Intestinal issues (Crohn’s disease/tapeworm)​

Overuse of stocks (pregnancy/haematological disease)​

Liver disease​

Malabsorption​

Drug treatments​

28
Q

Normocytic Anaemia​ causes

A

Acute blood loss​

Hereditary spherocytosis​

Haemolytic anaemias​

Auto immune disease​

Sickle cell

Anaemia of Chronic Disease (Cancer, kidney disease, renal failure, rheumatoid arthritis)​

29
Q

Hereditary Haemolytic Anaemias (HHAs)

A

Anaemia caused by an increased rate in RBC destruction

includes Hereditary spherocytosis (HS)

30
Q

Hereditary spherocytosis (HS)

A

Hereditary spherocytosis (HS):
– mutation = malfunctional proteins that cause interactions between the cytoskeleton and lipid bilayer of the red cell
– lipid bilayer of RBC membrane unsupported by cytoskeleton
– cells become spherical

31
Q

Hereditary spherocytosis (HS) – Clinical features​

A

Variable clinical picture (severe neonatal haemolytic anaemia to an asymptomatic state)​

Presents at any age​

Jaundice fluctuates​

Splenomegaly in the majority of cases​

Autosomal dominant​

32
Q

How would Hereditary spherocytosis (HS) present of blood film?

A

Reticulocytes (immature red cells)​

Spherocytes​

Reduced MCV but raised MCH (the cells are dense with haemoglobin)​

Anaemia – severity is similar in family members​

33
Q

Autoimmune Haemolytic Anaemia (AIHA)

A

immune cells attacking RBCs

34
Q

what does warm/cold Autoimmune Haemolytic Anaemia refer to?

A
35
Q

Describe a treatment plan for someone with iron deficiency anaemia:​

A

drugs in the form of

36
Q
A

Y2 HIT (Fri) (12 decks)

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