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Intersystem > Anaemia > Flashcards

Anaemia Flashcards

1
Q

Anaemia refers to

A

not enough red cells

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2
Q

Pancytopenia

A

not enough of all cells - RBC WBC and platelets

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3
Q

Leukopaenia

A

not enough white cells

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4
Q

Neutropaenia

A

not enough neutrophils

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5
Q

Lymphopaenia

A

not enough lymphocytes

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6
Q

Thrombocytopaenia

A

not enough platelets

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7
Q

Polycythaemia

A

too many red cells

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8
Q

Leukocytosis

A

too many white cells

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9
Q

Thrombocytosis

A

too many platelets

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10
Q

Dyserythropoiesis

A

dysfunctional red cells

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11
Q

White cell function defect

A

dysfunctional white cells

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12
Q

Platelet function defect

A

dysfunctional platelets

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13
Q

What is measured to determine anaemia?

A

Hb rather than red cell count

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14
Q

Anaemia is defined as

A

Hb level below that which is normal for age and sex

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15
Q

What determines the need for transfusion?

A

how long they can maintain O2 delivery and what kind of stress their heart is under to do so (and how they can cope)

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16
Q

The first step in assessing a patient with anaemia is

A

ASSESS HR!!

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17
Q

Anaemia can result in reduced oxygen to tissues unless _______ comoensates

A

CO increases to compensate

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18
Q

T/F SV can increase to compensate for anaemia

A

True in cases of dietary iron deficiency where the anaemia progresses over a long time

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19
Q

Acute onset anaemia presents with

A

increased HR

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20
Q

Clinical signs of anemia include

A 
Pale
Lethargic
Failure to thrive (chronic in children)
Hypoxic
Ischaemia
Tachycardia
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21
Q

What are common behavioural signs of hypoxia?

A

distressed, thrashing, not making sense, odd behaviour, disorientation, confusion

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22
Q

Hypoxia is an indicator of anaemia; what is an example?

A

Hypoxic behaviour in a child with congenital heart disease - his Hb is 140 which would be normal BUT he is compensating for the 70% O2 sat due to his congenital heart disease - therefore his normal Hb is 200 and an Hb of 140 is anaemia in this patient

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23
Q

Anaemia can complicate

A

coronary artery disease, causing stroke; carotid disease, causing stroke - both have compromised tissue O2 delivery

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24
Q

What are the causes of anemia?

A

Failure of production
Increased destruction/loss
Inappropriate production

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25
Q

What are the clinical investigations in anaemia?

A

FBE (for Hb) w/blood film

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26
Q

MCV

A

mean corpuscular volume

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27
Q

MCH

A

mean corpuscular Hb

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28
Q

Blood film tells us about

A

morphology of RBCs, WBCs, and platelets

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29
Q

Normocytic

A

normal sized red cells

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30
Q

Microcytic

A

small red cells

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31
Q

Macrocytic

A

large red cells

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32
Q

Normochromic

A

normal colour red cells

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33
Q

Hypochromic

A

not enough Hb in red cell

34
Q

Polychromatic

A

immature RBC with retained RNA - being pushed out of BM before it is ready

35
Q

How is anaemia clinically classified?

A

loss/destruction vs. failure

micro/normo/macrocytic (if BM problem)

36
Q

If anaemia is due to loss or destruction (BM working overtime), Hb declines

A

rapidly; need to act quickly

37
Q

If anaemia is due to BM failure (not working), Hb declines

A

Hb drops ~1g/week; time to work out why

38
Q

Morphological description of red cells is used when anaemia is due to

A

BM problem

39
Q

Signs of increased red cell production include

A

increased reticulocytes (polychromatic) in peripheral blood

40
Q

Signs of increased red cell destruction include

A

jaundice due to increased serum bilirubin; haptoglobins and LDH

41
Q

Signs of anaemia due to blood loss

A

on Hx and examination - is it overt or covert

42
Q

What are the two important causes of anaemia due to increased destruction and loss of red cells?

A

Blood loss and haemolysis

43
Q

Haemolysis is due to causes either ______ or _______ to the red cell

A

internal or external

44
Q

Causes of haemolysis internal to the red cell affect

A

membrane, enzyme (G6P), or Hb

45
Q

Causes of haemolysis internal to the red cell are a result of

A

immune mediated, mechanical, or infection

46
Q

Failure of blood cell production is due to

A

Lack of haematinics
Marrow failure or suppression
Marrow invasion

47
Q

Microcytic anaemia is due to

A

iron deficiency or thalassaemia, rarely lead poisoning, seroblastic anaemia

48
Q

If there is a microcytic anaemia, what needs to be determined?

A

is it a dietary deficiency in iron or is their blood loss eg colon cancer in an adult

49
Q

Macrocytic anaemia is due to

A

B12 or folate deficiency; liver disease, inherited BM failure syndromes, dyserythropoieses, drugs

50
Q

Bone marrow is investigated by

A

aspirate and smear

trephine coring biopsy - histo specimen

51
Q

Bone marrow aspirate tells us about

A

morphology of cells eg for laeukaemia

52
Q

Trephine of bone marrow tells us about

A

architecture of BM eg for tumours (patches of abnormal cells)

53
Q

Tx of anaemia

A

cause specific - replace dietary deficiencies, stop haemolysis or causative drug use, transfusion

54
Q

ABO genes are on chromosome __ whereas H genes are on chromosome __

A

9, 19

55
Q

Blood group antigens are located

A

on the surface of RBCs - define blood group

56
Q

The precursor substance on red cells is

A

H substance - depending on genes, converted to A, B, AB, or O antigen

57
Q

The H gene encodes for ________ which converts ____ to ____________

A

H transferase; PS to H Ag

58
Q

ABO genes encode for ______ which __________

A

transferase enzymes which add sugars to the H substance, determining the blood group ie A codes for A, converts H to A

59
Q

Most common blood groups are

A

A and O (30-40%; B only 11%)

60
Q

The least common blood type is

A

AB (3%)

61
Q

Rh antigens include

A

C, c, D, E, e

62
Q

Genes for Rh Ag are on chromosome

A

1

63
Q

Rh+ means

A

D positive (DD, Dd)

64
Q

Rh- means

A

D negative (dd)

65
Q

Rh positivity differs with

A 
ethnicity:
Chinese 100%
European 84%
West African 95%
Australian 98%
66
Q

Blood group antibodies are

A 
Naturally occurring:
A has anti-B Abs
B has anti-A Abs
AB has none
O has both anti-A and anti-B Abs
67
Q

ABO antibodies are ________ while Rh antibodies are _______

A

ABO are naturally occurring whereas Rh are induced by exposure

68
Q

Exposure to Rh Ag occurs

A

via blood transfusion or during pregnancy

69
Q

Rh group antibodies are

A

induced by exposure

70
Q

Rh- mum carrying an Rh+ baby, what happens if the blood crosses the placenta?

A

Mum gets immunized and makes Rh+ Abs that attack the Rh+ red cells in the fetus - haemolytic disease of the newborn

71
Q

Haemolytic disease of the newborn occurs when

A

anti-Rh+ Abs are generated to an Rh- mum reacting to blood from an Rh+ baby; destroy fetal RBCs

72
Q

Haemolytic disease of the newborn is treated with

A

anti-D

73
Q

T/F cells and plasma have the same blood group compatabilities

A

False; cells and plasma have opposite compatabilities

74
Q

A blood can receive blood from

A

A or O

75
Q

B blood can receive blood from

A

B or O

76
Q

AB can receive blood from

A

anyone

77
Q

O blood can receive blood from

A

O only

78
Q

Which blood type is considered the universal donor?

A

O

79
Q

Which blood type is considered the universal recipient?

A

AB

80
Q

Rh+ blood can receive blood from

A

Rh+ or Rh-

81
Q

Rh- blood can receive blood from

A

Rh -ve only

Intersystem (5 decks)

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