Anaemia Flashcards
What is anaemia?
Reduction in haemoglobin in the blood from the normal values for that population.
What are the three broad causes of anaemia?
Reduced production
Increased losses
Increased demand
What is aplastic anaemia?
Reduced red cells caused by issues within the bone marrow.
What are the three haematinics?
Iron
Folate
Vitamin B12
What food sources have iron?
Meat
Green leafy vegetables
Iron tablets
How is iron absorbed in the body?
Iron is absorbed through the intestinal wall via 2 ways.
Non-haem is converted from Fe3+ to Fe2+ via stomach acid and taken through a transporter in the cell wall.
Haem iron is absorbed directly through a transporter in the cells wall.
Both are converted to ferritin
Then taken to the blood and transported to marrow and liver by transferrin.
Name some diseases which can reduce iron absorption?
Achlorhydria
Coeliac disease
What conditions can cause iron loss?
Crohn’s
Ulcerative colitis
Bowel cancer
Gastric erosion and ulcers
What is the function of iron in the body?
Used to make haemoglobin.
What food sources provide vitamin B12?
Meat and dairy
How is vitamin B12 absorbed in the body?
Vitamin B12 binds to intrinsic factor in the stomach.
This complex is taken to the the ileo-caecal junction and absorbed here.
How is folic acid absorbed?
Same way as iron.
What conditions may cause vitamin B12 deficiency?
Vegans
Autoimmune stomach disease- pernicious aneamia
Gastric disease
Crohn’s disease
What sources in the diet provide folic acid?
Green leafy vegetables.
What conditions may result in folic acid deficiency?
Lack of intake
Coeliac disease- absorption failure
What conditions can folic acid cause during foetal development?
Neural tube defects- spina bifida.
What is Thalassemia?
Normal haem production but there is genetic mutation of global chains.
What are the clinical effects of Thalassaemia?
Chronic anaemia
Marrow hyperplasia
Splenomegaly
Cirrhosis
Gallstones
What is sickle cell anaemia?
Abnormal global chains
- RBC change shape in low oxygen environments.
- Prevents RBC from passing through the capillaries, causes tissue ischaemia.
What are the signs and symptoms of anaemia?
Pale mucosa
Glossitis
Beefy tongue- vit B12
Tired and weak
Dizzy
Palpitations
SOB
What causes microcytic anaemia?
Iron deficiency
What causes microcytic anaemia?
Vitamin B12 and folate.
If someone is anaemia but has normal RBC, what would this suggest?
Blood loss.
Why is GA not advised for anaemics?
They have a reduced oxygen capacity.
What are the constituents of blood?
RBC, WBC and platelets.
Plasma proteins- albumin and globulin
Lipids
Nutrients
Water
What is leukopenia?
Low WCC.
What is thrombocytopenia?
Low platelets.
What is thrombocythaemia?
High platelets.
What is leukocytosis?
Raised WCC.
Where are red blood cells and platelets made?
In the bone marrow- form the myeloid stem cells lineage.
What cells are produced from myeloid lineage?
RBC
Platelets
Neutrophils
Eosinophils
monocytes
Basophils
What cells are produced from lymphoid lineage?
T and B cells.
What is the lower limit of platelets for an extraction?
If below 50, the patient will need a platelet transfusion before the extraction.
What are the oral conditions associated with haematinic deficiency?
Oral ulceration
Fungal and viral infections
Painful mucosa- mucosal atrophy
