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Haematology > Anaemia > Flashcards

Anaemia Flashcards

1
Q

What are the causes of microcytic anaemia? (5)

A

TAILS

• T – Thalassaemia
• A – Anaemia of chronic disease
• I – Iron deficiency anaemia
• L – Lead poisoning
• S – Sideroblastic anaemia
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2
Q

What is the most common cause of anaemia of chronic disease?

A

CKD

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3
Q

How does CKD cause anaemia?

A

Causes reduced erythropoietin by the kidneys
This usually stimulates RBC production

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4
Q

Where is erythropoietin produced?

A

Kidneys

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5
Q

How do you treat anaemia of chronic disease cause by CKD?

A

Supplement iron first to correct low iron if there
Then treat with erythropoietin

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6
Q

What are the causes of normocytic anaemia? (5)

A

3As 2Hs

• A – Acute blood loss
• A – Anaemia of chronic disease
• A – Aplastic anaemia
• H – Haemolytic anaemia
• H – Hypothyroidism

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7
Q

What are the 2 groups of macrocytic anaemia? What are they caused by? (2 + 5)

A

Megaloblastic anaemia is caused by:
• B12 deficiency
• Folate deficiency

Normoblastic macrocytic anaemia is caused by:
	○ Alcohol
	○ Reticulocytosis (usually from haemolytic anaemia or blood loss)
	○ Hypothyroidism
	○ Liver disease
	○ Drugs, such as azathioprine
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8
Q

What is the mechanism of megaloblastic anaemia?

A

Impaired dna synthesis from vitamin deficiency causes the cells not to divide normally
They grow into large abnormal cells rather than dividing

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9
Q

What 2 things can cause reticulocytosis?

A

Haemolytic anaemia
Blood loss

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10
Q

What are some generic symptoms of anaemia? (6)

A

• Tiredness
• Shortness of breath
• Headaches
• Dizziness
• Palpitations
• Worsening of other conditions, such as angina, heart failure or peripheral arterial disease

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11
Q

What are 2 symptoms specific to iron deficiency anaemia?

A

○ Pica (dietary cravings for abnormal things, such as dirt or soil)
○ Hair loss

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12
Q

What are some generic signs of anaemia? (4)

A

• Pale skin
• Conjunctival pallor
• Tachycardia
• Raised respiratory rate

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13
Q

What is koilonychia and what’s it a sign of?

A

Spoon shaped nails
Iron deficiency anaemia

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14
Q

What is angular chelitis a sign of?

A

Iron deficiency anaemia

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15
Q

What is atrophic glossitis and what is it a sign of?

A

Smooth tongue due to atrophy of the papillae
Iron deficiency anaemia

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16
Q

What anaemia can brittle hair and nails be a sign of?

A

Iron decicin

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17
Q

What anaemia is jaundice a sign of?

A

Haemolytic anaemia

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18
Q

What tests must be done in unexplained anaemia? (2)

A

OGD
Colonoscopy

19
Q

What is the serum iron, % saturation, ferritin and TIBC levels in iron deficiency anaemia?

A

Serum iron = low
% saturation = low
Ferritin = low (all of the stored iron is used up because serum iron is depleted)
TIBC = high

20
Q

What is the serum iron, % saturation, ferritin and TIBC levels in anaemia of chronic disease?

A

Serum iron = low
% saturation = low
Ferritin = High (due to built-up stores from hepcidin)
TIBC = low

21
Q

What is the serum iron, % saturation, ferritin and TIBC levels in sideroblastic anaemia?

A

Serum iron = High (iron builds up in cells and released into serum once the cell bursts)
% saturation = high
Ferritin = high (iron in overloaded state)
TIBC = low

22
Q

What anaemia shows these iron results:
Low serum iron
Low % saturation
Low ferritin
High TIBC?

A

Iron deficiency anaemia

23
Q

What anaemia shows these iron results:
Low serum iron
Low % saturation
High ferritin
Low TIBC?

A

Anaemia of chronic disease

24
Q

What anaemia shows these iron results:
High serum iron
High % saturation
High ferritin
Low TIBC?

A

Sideroblastic anaemia

25
Q

What 2 things are special about RBCs in iron deficiency anaemia?

A

Microcytic
Haemochromic = pale due to low Hb

26
Q

What are the 4 general causes of iron deficiency anaemia?

A

• Insufficient dietary iron
• Iron requirements increase (for example in pregnancy)
• Iron is being lost (for example slow bleeding from a colon cancer)
• Inadequate iron absorption

27
Q

Where is iron mainly absorbed? (2)

A

Duodenum
Jejunum

28
Q

What is the soluble form of iron?

A

Ferrous Fe2+

29
Q

What is the insoluble form of iron?

A

Ferric Fe3+

30
Q

What feature of the stomach keeps iron in its soluble form?

A

Acid

31
Q

How do PPIs affect iron absorption?

A

Reduces it as it reduces acid in the stomach so iron becomes more insoluble

32
Q

What diseases can cause inflammation in the duodenum and jejunum .: causing poor iron absorption? (2)

A

Coeliac disease
Crohn’s disease

33
Q

What is the most common cause of anaemia in adults?

A

Blood loss

34
Q

What is the most common cause of iron deficiency anaemia in growing children?

A

Dietary insufficiency

35
Q

What is the word for heavy periods?

A

Menorrhagia

36
Q

When is serum ferritin raised?

A

Inflammation

37
Q

How is transferrin saturation calculated?

A

Serum iron / TIBC

38
Q

What can a high ferritin indicate? (4)

A

Inflammation
Liver disease
Iron supplements
Haemochromotosis

39
Q

You are investigating for iron deficiency anaemia and ferritin is normal. What does this mean?

A

Can’t rule out that they don’t have iron deficiency anaemia even though ferritin is not low
Could be low and then slightly raised by something like inflammation

40
Q

What is the main treatment of iron deficiency anaemia?

A

Oral iron
Ferrous surface 200mg 3 times a day

41
Q

What are some side effects of iron supplementation? (2)

A

Constipation
Black stools

42
Q

When are iron infusions avoided?

A

Sepsis
Iron could possibly feed the bacteria

43
Q

What is there a risk of with iron infusions?

A

Anaphylaxis

Haematology (18 decks)

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