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MBBS 3: Internal Medicine > Anaemia > Flashcards

Anaemia Flashcards

1
Q

What produces RBCs in the bone marrow?

A

pluripotent stem cells

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2
Q

Chemical regulation of the bone marrow is done by?

A
  1. Cytokines
  2. Erythroid specific growth factor
  3. Erythropoietin (EPO)
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3
Q

What is the lifespan of a reticulocyte?

A

4 days

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4
Q

What is the lifespan of a RBC?

A

120 days

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5
Q

What is anaemia?

A

values of hemoglobin, hematocrit or RBC counts which are more than 2 standard deviations below the mean

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6
Q

Anaemia values for men and women?

A
  1. HGB
    <13.5 g/dL (men)
    <12 (women)
  2. HCT
    <41% (men)
    <36 (women)
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7
Q

What symptoms would indicate decreased oxygen delivery to tissues?

A
  1. Exertional dyspnea
  2. Dyspnea at rest
  3. Fatigue
  4. Signs and symptoms of hyperdynamic state e.g. Bounding pulses, Palpitations
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8
Q

Life threatening conditions that can causes decreased oxygen delivery to tissues?

A
  1. heart failure
  2. angina
  3. myocardial infarction
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9
Q

Signs and symptoms of hypovolemia?

A
  1. Fatiguability
  2. postural dizziness
  3. lethargy
  4. hypotension
  5. shock and death
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10
Q

Physical examination findings of an anemia patient?

A
  1. Pallor
  2. Jaundice
    - haemolysis
  3. Lymphadenopathy
  4. Hepatosplenomegally
  5. Bony Pain
  6. Petechiae
  7. Rectal
    - Occult blood
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11
Q

Initial testing of anemia?

A
  1. FBC w/ differential (includes RBC indices)
  2. Reticulocyte count
  3. Peripheral blood smear
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12
Q

Specific tests for bleeding?

A
  1. HCT
  2. Hb
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13
Q

Lab tests for iron deficiency?

A

iron studies
- ferritin

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14
Q

Lab tests for hemolysis?

A
  1. Serum LDH
  2. indirect bilirubin
  3. haptoglobin
  4. Coombs
  5. coagulation studies
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15
Q

Lab tests directed by clinical indication?

A
  1. haemoglobin electrophoresis
  2. B12/folate levels
  3. bone marrow examination
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16
Q

Classification of anemia by pathophysiology?

A
  1. Blood Loss
  2. Decreased Production
  3. Increased Destruction
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17
Q

Classification of anemia by morphology?

A
  1. Normocytic
  2. Microcytic
  3. Macrocytic
18
Q

Causes of acute blood loss?

A
  1. Traumatic
  2. Variety of sources
    - Melena, haematemesis, menometrorrhagia
19
Q

Causes of chronic blood loss?

A

Occult bleeding
- Colonic polyp/carcinoma

20
Q

Causes of decreased production in anemia?

A
  1. Infections
  2. Neoplasms
  3. Endocrine
  4. Nutritional Deficiency
  5. Anaemia of Chronic Disease
21
Q

Infectious causes of decreased production in anemia?

A
  1. Bacterial
    - Tuberculosis
    - MAC
  2. Viral
    - HIV
    - Parvovirus
22
Q

Neoplasms that cause decreased production in anemia?

A
  1. Leukaemia
  2. Lymphoma/Myeloma
  3. Myeloproliferative Syndromes
  4. Myelodysplasia
23
Q

Endocrine causes that cause decreased production in anemia?

A
  1. Thyroid Dysfunction
    - Hypothyroidism
  2. Erythropoietin Deficiency
    - Renal failure
24
Q

Nutritional deficiencies that cause a decreased production in anemia?

A
  1. Iron
  2. B12
  3. Folate
25
Q

Hemolytic anemias that cause increased destruction of RBCs?

A
  1. Immune mediated
  2. Non-immune mediated
26
Q

Immune mediated anemias?

A
  1. Cold agglutinin
    - Paroxysmal nocturnal haemoglobinuria
    - Post mycoplasmal haemolytic anaemia
  2. Warm agglutinin
    - Drug induced
    - Autoimmune haemolytic anaemia
    - Transfusion reaction
27
Q

Non-immune mediated anemia?

A
  1. extra-corpuscular
  2. intra-corpuscular
28
Q

Non immune mediated extra-corpuscular anemia?

A
  1. Macro-circulatory
    - Hypersplenism
    - Extracorporeal circulation
  2. Micro-circulatory
    - DIC
    - TTP
    - HUS
29
Q

Non-immune mediated intra-corpuscular anemia?

A
  1. RBC Wall (membrane or enzyme defects)
  2. Haeme or globin abnormalities (HbS, C)
30
Q

Causes of normocytic anemia?

A
  1. Infections
  2. Malignancy
  3. Early Anaemia of Chronic Disease
  4. Acute blood loss
  5. Obesity
  6. Bone marrow failure
31
Q

Causes of anemia of chronic disease in normocytic anemia?

A
  1. CKD
  2. Heart failure
  3. Immune mediated disease
    e.g. RA, Lupus, vasculitis, sarcoidosis, inflammatory bowel disease
32
Q

Causes of microcytic anemia?

A
  1. MCV <80
  2. Reduced iron availability
  3. Reduced haeme synthesis
  4. Reduced globin production
33
Q

Causes of reduced iron availability in microcytic anemia?

A
  1. iron deficiency
  2. anemia of chronic disease
34
Q

Causes of iron deficiency anemia?

A
  1. Deficient diet/absorption
  2. Increased requirements
  3. Blood loss
  4. Iron sequestration
35
Q

Causes of anemia of chronic disease?

A
  1. Low serum iron, low TIBC, normal serum ferritin
  2. Chronic infection
  3. inflammation
  4. cancer
  5. liver disease
36
Q

Causes of reduced heme synthesis in microcytic anemia?

A
  1. Lead poisoning
  2. Acquired or congenital sideroblastic anaemia
  3. Characteristic smear finding: basophylic stippling
37
Q

Causes of reduced globin production in microcytic anemia?

A

thalassemia

38
Q

Smear characteristics of reduced globin production in microcytic anemia?

A
  1. Hypochromia
  2. Microcytosis
  3. Target Cells
  4. Tear Drops
39
Q

Causes of macrocytic anemia?

A
  1. MCV > 100
  2. megaloblastic
  3. non-megaloblastic
40
Q

Causes of megaloblastic macrocytic anemia?

A
  1. Abnormalities in nucleic acid metabolism
  2. B12
  3. Folate
41
Q

Causes of non-megaloblastic macrocytic anemia?

A
  1. Abnormal RBC maturation
  2. Myelodysplasia
  3. ETOH
  4. liver disease
  5. hypothyroidism
  6. chemotherapy/drugs

MBBS 3: Internal Medicine (72 decks)

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