ANAEMIA

Question 1

Anaemia

Answer 1

reduction of haemoglobin in the blood

Question 2

how do haemoglobin issues arrise

Answer 2

inability to make the haem (iron def)
inability to make the correct globin chains (sickle cell)

Question 3

anaemia causes

Answer 3

1. reduced production
2. increased losses
3. increased demand

Question 4

reduced production of haemoglobin

Answer 4

nutrition
malabsorption

Question 5

increased losses of haemoglobin

Answer 5

blood loss
intravascular haemolysis

Question 6

increase haemoglobin demand

Answer 6

increased utilisation - pregnancy, growth

Question 7

disease reducing iron absorption

Answer 7

achlorydia
coeliac disease

Question 8

achlorhydia

Answer 8

lack of stomach acid
no conversion of non-haem iron

Question 9

diseases causing iron loss

Answer 9

gastric erosions/ ulcers
IBD
Bowel cancer
haemorrhoids

Question 10

causes of Vit B12 def

Answer 10

lack of intake - vegans
lack of intrinsic factor - pernicious anaemia
disease of terminal ilium

Question 11

lack of intrinsic factor due to

Answer 11

autoimmune stomach disease (pernicious anaemia)
gastric disease

Question 12

disease of terminal ilium

Answer 12

crohns diasease

Question 13

folic acid def cause

Answer 13

lack of intake
absorption failure

Question 14

absorption failure of folic acid cause

Answer 14

jejunal disease (coeliac)

Question 15

abnormal globin chains

Answer 15

sickle cell
thalassaemia

Question 16

thalassaemia

Answer 16

normal haem production
genetic mutation of globin chains

Question 17

clinical effects of thalassaemia

Answer 17

chronic anaemia
marrow hyperplasia - skeletal deformities
splenomegaly
cirrhosis
gallstones

Question 18

thalassaemia management

Answer 18

blood transfusion
prevent iron overload

Question 19

sickle cell anaemia

Answer 19

abnormal globin chains

Question 20

sickle cell anaemia effects

Answer 20

haem change shape in low 02 environments
prevent RBC from passing through cappilaries
tissue ischaemia (pain and necrosis)

Question 21

measure degree of anaemia

Answer 21

measure Hb

Question 22

measure cell deficiency or Hb formation def,

Answer 22

RCC and HCT

Question 23

measure overall picture

Answer 23

MCV
(size of cell)

Question 24

types of anaemia RCC and HCT losses

Answer 24

lose normal red cells through bleeding - GI
abnormal red cells with reduced lifespan and removed by spleen - autoimmune/ hereditary

Question 25

anaemia classifications

Answer 25

microcytic
macrocytic
normocytic
hypochromic
ansiocytic

Question 26

ansiocytic

Answer 26

exaggerated sizes of cells
really big and really small

Question 27

reticulocyte

Answer 27

almost mature RBC - released early into circulation to replace losses

Question 28

reticulocytosis effect

Answer 28

raised MCV

Question 29

anaemia signs

Answer 29

pale
tachycardia
enlarged liver and spleen (RARE)
pale mucosa
smooth tongue
angular cheilitis
beefy tongue

Question 30

anaemia symptoms

Answer 30

tired and weak
dizzy
SOB
palpitations

Question 31

anaemia investigations

Answer 31

good history
FBC
GI blood loss - FOB, endoscopy/ colonoscopy
Renal function
Bone marrow exam

Question 32

anaemia Tx

Answer 32

replace haematinics
transfusions
erythropoietin

Question 33

replacing haematinics

Answer 33

FeSO4 200mg tds for 3 months
1mg IM vitB12 x 6 then 1mg/2 months
5mg folic acid daily

Question 34

production failure/ renal disease tx

Answer 34

erythropoietin