Anaemia Flashcards
What is DAT?
What disease can this show?
What red blood cells are present in this disease?
Direct antiglobulin test
Some spherocytes develop auto antibodies
Positive sign uses rabbit antibodies and see if there is aggregation
Autoimmune haemolytic anaemia
Spherocytes
What is G6PD enzyme deficiency anaemia?
Will the patient have jaundice? How will bilirubin be affected?
What cells will be seen on a blood film?
What advice would you give the patient?
Anaemia caused by a def in G6PD needed in glycolytic pathway- this pathway protects red blood cells from oxidant damage
Jaundice, high unconjugated bilirubin
Ghost cells and Heinz bodies can be seen
Advice: avoid broad beans, avoid oxidant drugs
What are the causes of iron deficiency anaemia?
Increased blood loss- Heavy period or GI problems
Insufficiency iron intake- Vegetarians or Malabsorption
Increased iron requirements- pregnancy or infancy
What cells can be seen in iron deficiency anaemia?
How will the following substances on their blood film show?
MCHC
MCV
Hb
Ferritin
Transferrin
Hepcidin
What is ferritin, hepcidin and trasnferrin?
Pale cells - hypochromia due to low MCHC
small cells- low Mcv
Target cells
Pencil cells
Low mchc
Low mcv
Low hb
LOW ferritin- stores iron in the body
High transferrin but low saturation % of it- protein that controls absorption of iron from the gut
Low hepcidin- protein that inhibits absorption of iron from the gut
What is anaemia of chronic disease?
How does inflammation cause anaemia?
Are they expected to be bleeding, have reduced rbc survival, or be deficient in iron, folate or b12?
Anaemia caused by a chronic disease that involves inflammation
Inflammation causes an increase in hepcidin, hepcidin causes reduced iron supply by blocking absorption and release from stores
No- the anaemia is coming as a secondary effect to another disease
Does a normal ferritin always exclude iron deficiency?
Which two types of anaemia can have a normal ferritin?
What type of anaemia are they both examples of?
No
Ferritin can be normal if you have both iron deficiency and anaemia of chronic disease
They are both examples of microcytic anaemia
What is megaloblastic anaemia? What is the pathophysiology?
What film of what organ can these cells be seen in?
Big red blood cells
Nucleus stays big during maturation even when cytoplasm starts turning pink- can be seen in bone marrow
What are the causes of megaloblastic (macrocytic) anaemia?
What can be seen on the following:
MCV
Hb
B12
Bilirubin
B12 deficiency or folic acid deficiency
High mcv
Low hb
Low b12
High bilirubin
What can cause b12 deficiency and folic acid deficiency?
Where are each of these absorbed in the GI tract?
How does the cause behind their deficiency affect the treatment recommended?
B12- chicken, milk, nut deficiency
Pernicious anaemia (anti IF)
Chrons disease or iléal resection
Absorbed in the ileum
Folic acid- diet, coeliac disease in jéjunum, pregnancy and lactation
Absorbed in jéjunum
If absorption is the issue, injection or parentéral therapy will be preferred over oral supplements, as these will not be absorbed
What are the two main causes that can lead to anaemia?
Haemolytic
Low production of RBCs
What is hereditary spherocytosis?
What type of anaemia is it?
What levels of Hb can you except in this type of anaemia?
What treatment should be given to someone with this anaemia?
How will reticulocyte count be affected by this type of anaemia?
A defect in the red cell membrane causing a dip in the BC (no central pallor), caused by ankyrin/spectrin
Haemolytic anaemia
Low Hb
Folic acid- for erythropoiesis
Splenectomy if severe to increase red cell life span
Reticulocyte count will increase due to the reduced RBC life span POLYCHROMASIA
What does haemoglobin produce when broken down?
What can this substance create and therefore cause as another disease?
Bilirubin
Gall stones- obstructive jaundice
When is bilirubin conjugated and unconjugated?
What is is conjugated to in its conjugated form?
UnConjugated whilst in the blood bound to albumin
Conjugated whilst in the liver
How will the following substances be affected in haemolytic anaemia:
Reticulocyte count
Unconjugated bilirubin
LDH
MCV
Hb
Increased
Increased
Increased
Increased
Decreased
What two types of haemolytic anaemia are spherocytes found in?
Hereditary- hereditary spherocytosis
Acquired- autoimmune eg SLE
