Anaemia Flashcards
What is the most common type of anaemia?
Iron deficiency anaemia
What is the main cause of iron deficiency anaemia?
Inadequate dietary intake of iron
What are the 3 main types of anaemia and how do you investigate for each one?
Microcytic MCV <80 - iron studies
Normocytic MCV 80-100 - reticulocyte count
Macrocytic MCV >100 - blood film
What are the symptoms of anaemia?
Fatigue
weakness
pallor
shortness of breath
dizziness
palpitations
Cold peripheries
What is the treatment for iron deficiency anaemia?
Iron supplementation 50-100mg and dietary changes
What is pernicious anaemia?
Autoimmune disorder affecting gastric mucosa
Antibodies against intrinsic factor - block b12 binding site and antibodies for gastric parietal cells reduce acid production and atrophic gastritis leading reduced intrinsic factor - reduced b12 absorption
Leads to B12 deficiency -> megaloblastic anaemia and neuropathy
What is the primary function of red blood cells?
To carry oxygen from the lungs to the rest of the body
What is the term for the process of red blood cell production?
Erythropoiesis
What is the hormone responsible for stimulating erythropoiesis?
Erythropoietin
What is the term for the destruction of red blood cells?
Hemolysis
What is the most common symptom of sickle cell anaemia?
Painful vaso-occlusive crises
What is the genetic mutation that causes sickle cell anaemia?
Hemoglobin S
What is the treatment for acute chest syndrome in sickle cell?
Pain relief
Resp support e.g. oxygen therapy
Abx
Blood transfusion
Features of pernicious anaemia?
Anaemia features - pallor, lethargy, dysponea
Neurological features - peripheral neuropathy typically symmetrical legs more than arms
subacute combined degeneration of the spinal cord - ataxia, progressive weakness, parasthesia progress to spasticity and paraplegia
Neuropsychiatric features - memory loss, poor concentration, confusion, depression, irritability
Other features
Mild jaundice (lemon tinge)
Atrophic glossitis
What is the term for anaemia caused by a decrease in red blood cell production due to bone marrow failure?
Aplastic anaemia
What is the term for anaemia caused by an autoimmune reaction against red blood cells?
Autoimmune hemolytic anaemia
What is the term for anaemia caused by an inherited defect in the red blood cell membrane?
Hereditary spherocytosis
What is the term for the inherited disorder that results in abnormal hemoglobin production?
Thalassemia
What is the most common type of thalassemia?
Beta thalassemia
What is the treatment for thalassemia?
Repeated Blood transfusions - can lead to iron overload and organ failure
Iron chelation therapy important
What are the types of macrocytic anaemia and what is seen on blood film?
Megaloblastic - large immature RBC with hyper-segmented neutrophils
Non-megaloblastic - large mature RBC
What is the term for anaemia caused by a decrease in red blood cell lifespan due to conditions like sickle cell disease or thalassemia?
Hemolytic anaemia
Intravascular causes of haemolytic anaemia?
Disseminated intravascular coagulation
Thrombotic thrombocytopenic purpura
Haemolytic ureamic syndrome
Mechanical heart valve
Normocytic anaemia with high reticulocyte count?
Haemolytic anaemia
Blood loss
What is the term for anaemia caused by a decrease in red blood cell production due to bone marrow suppression or failure?
Aplastic anaemia
Causes of microcytic anaemia?
Thalassaemia
Anaemia of chronic disease
Iron deficiency
Lead poisoning
Sideroblastic anaemia
Investigations for haemolytic anaemia?
LDH (increased)
Reticulocytes (increased)
Bilirubin (increased)
Haptoglobin (decreased as more is bound to free Hb)
What are the clinical findings of anaemia?
General or conjunctival pallor
Rapid or irregular heartbeat
Hepatomegaly, splenomegaly (consider lymphoma or leukaemia)
Pelvic or rectal exam may be indicated to assess for blood loss
What are the possible causes of megaloblastic anaemia?
Vitamin B12 deficiency
Folate deficiency
Drug induced
What are the possible causes of non-megaloblastic anaemia?
Alcohol abuse
Hypothyroidism
Pregnancy
Causes of extravascular haemolytic anaemia?
Hypersplenism
Sickle cell anaemia
Spherocytosis
Malaria
Normocytic anaemia with low reticulocyte count?
Bone marrow disorder (aplastic anaemia)
What do you transfuse for DIC?
Platelets (as low plts)
Cryoprecipitate (as low fibrinogen)
FFP (for APTT and PT)
Triggers for DIC
Malignancy
Sepsis
Trauma
Burns
Obstetric emergency
