Anaemia

Question 1

what is anaemia?

Answer 1

a reduction in haemoglobin in the blood (below normal for the population)

Question 2

does anaemia mean a reduction in red blood cells?

Answer 2

not necessarily

Question 3

what are the 3 causes of anaemia?

Answer 3

• reduced production
• increased losses
• increased demand

Question 4

what is meant by marrow failure?

Answer 4

marrow is not able to make RBCs that package haemoglobin

Question 5

what are haematinics?

Answer 5

things used to make RBCs

Question 6

give examples of haematinics?

Answer 6

• iron
• folate
• vit B12

Question 7

what are some sources of iron?

Answer 7

• meat
• green leafy vegetables
• iron tablets

Question 8

how is haem iron dissolved?

Answer 8

dissolved specifically through a transporter system direct in the intestinal wall

Question 9

how does NON-HAEM IRON differ from HAEM IRON?

Answer 9

• non-haem must be converted from Fe3+ to Fe2+ before being absorbed

Question 10

what is iron stored as inside the cell?

Answer 10

FERRITIN

Question 11

what iron is easier to deal with?

Answer 11

haem iron?

Question 12

what are some diseases that reduce iron absorption?

Answer 12

• achlorhydria

* coeliac disease

Question 13

what is achlorhydria?

Answer 13

• lack of stomach acid
• so no conversion of non-haem iron
• may be drug induced

Question 14

what drugs can cause achlorhydria?

Answer 14

proton pump inhibitors

Question 15

what is coeliac disease?

Answer 15

a disease that affects intestinal villi so absorption is affected

Question 16

what can iron loss be caused by?

Answer 16

• gastric errors and ulcers
• inflammatory bowel disease
• bowel cancer
• haemorrhoids

Question 17

why does inflammatory bowel disease and bowel cancer cause iron loss?

Answer 17

both cause GI tract bleeding

Question 18

how is vitamin B12 absorbed?

Answer 18

• intrinsic factor is secreted by gastric parietal cells
• intrinsic factor binds to vitamin B12 (taken in through diet)
• absorbed in the intestine

Question 19

where specifically is vitamin B12 absorbed?

Answer 19

the ILEUM

Question 20

what organ stores a lot of vitamin B12?

Answer 20

the liver

Question 21

how can vitamin B12 deficiencies occur?

Answer 21

• lack of intake
• lack of intrinsic factor
• disease of terminal ileum

Question 22

what autoimmune disease causes a lack of intrinsic factor?

Answer 22

pernicious anaemia

Question 23

what foods are rich in vitamin B12?

Answer 23

• meat
• dairy
• eggs

Question 24

what foods are rich in folate?

Answer 24

leafy green vegetables

Question 25

how can folic acid deficiencies occur?

Answer 25

* lack of intake | * absorption failure

Question 26

what can folic acid deficiency result in in pregnancy?

Answer 26

neural tube defect in foetus

Question 27

what diseases cause abnormal globin chains?

Answer 27

* thalassaemia | * sickle cell

Question 28

describe the haem production of thalassaemia:

Answer 28

normal haem production

Question 29

what are some clinical effects of thalassaemia?

Answer 29

* chronic anaemia * marrow hyperplasia * splenomegaly * cirrhosis * gallstones

Question 30

what is marrow hyperplasia?

Answer 30

bones expand producing skeletal abnormalities (normally seen in skull)

Question 31

how can thalassaemia be managed?

Answer 31

* blood transfusions | * prevent iron overload

Question 32

describe RBCs in a patient with sickle cell anaemia?

Answer 32

RBCs have curled up edges & are no longer able to squeeze through capillaries

Question 33

what is a microcytic cell?

Answer 33

small RBC

Question 34

what is a macrocytic cell?

Answer 34

large RBC

Question 35

what do large RBCs normally indicate ?

Answer 35

immature red blood cells are large

Question 36

what is a hypochromic cell?

Answer 36

RBCs are pale/lack colour due to less haemoglobin

Question 37

what is meant by ansiocytic cells?

Answer 37

red cell size range is very large (very big cells & very small cells)

Question 38

what is a red blood cell that is ALMOST mature?

Answer 38

reticulocytes

Question 39

what are some signs of anaemia?

Answer 39

* pale * tachycardia * enlarged liver (rare) * enlarged spleen (rare)

Question 40

what are the symptoms of anaemia?

Answer 40

* tired & weak * dizzy * shortness of breath * palpitations

Question 41

what are some physical traits of anaemia?

Answer 41

* pale mucosa * smooth tongue * beefy tongue

Question 42

how could you investigate a potential anaemia?

Answer 42

* check history of patient * full blood count * check for GI blood loss * bone marrow examination

Question 43

what are the treatments for anaemia?

Answer 43

* replace haematinics * transfusions * provide erythropoietin

Question 44

how are haematinics replaced?

Answer 44

* 1mg IM vitamin B12 every 2 months | * 5mg folic acid daily

Question 45

what are the dental implications of anaemia?

Answer 45

* lower O2 capacity related to general anaesthesia * mucosal atrophy * candidiasis * recurrent oral ulceration * sensory changes