Anaemia

Question 1

What is pancytopaenia?

Answer 1

not enough of red cells, white cells and platelets

Question 2

What is leukopaenia?

Answer 2

not enough white cells

Question 3

What is neutropaenia?

Answer 3

not enough neutrophils

Question 4

What is lymphopaenia?

Answer 4

not enough lymphocytes

Question 5

What is anaemia?

Answer 5

not enough red cells

Question 6

What is thrombocytopaenia?

Answer 6

not enough platelets

Question 7

What is polycythaemia?

Answer 7

too many red cells

Question 8

What is leukocytosis?

Answer 8

too many white cells

Question 9

What is thrombocytosis?

Answer 9

too many platelets

Question 10

What is dyserythropoeisis?

Answer 10

red cells dont work properly

Question 11

What is anaemia defined as?

Answer 11

a Hb level lower than normal for age and gender

Question 12

What is the equation for tissue oxygen delivery?

Answer 12

= CO x Hb x % saturation x 1.34

Question 13

Why is the equation for tissue oxygen delivery so important?

Answer 13

because it determines when to use blood, inotropes and oxygen

Question 14

What is a mechanism for monitoring anaemic patients?

Answer 14

measure their HR because it is a linear equation so as Hb decreses HR will increase

Question 15

What is the impact of anaemia?

Answer 15

reduced oxygen to tissues unless can compensate with increased CO

Question 16

What are the clinical signs of anaemia?

Answer 16

• Pale
• Lethargic
• Failure to thrive
• Hypoxic (disorientated, confused)
• Ischaemia
• tachycardia

Question 17

What are the three causes of anaemia?

Answer 17

failure of production, increased destruction/loss, inappropriate production

Question 18

What can be determined about red blood cells from a blood film?

Answer 18

the size (normocytic, microcytic, macrocytic), the shape and the colour (normochromic, hypochromic, polychromic)

Question 19

What is the cause of polychromasia?

Answer 19

the cell has too much RNA in it which means it is immature

Question 20

What are the signs of increased destruction?

Answer 20

more reticulocytes, polychromasia, jaundice, haptoglobins

Question 21

Why is it important to detect if the anaemia is caused by increased destruction or blood loss?

Answer 21

because Hb may fall rapidly because of it

Question 22

What is the most common cause of anaemia caused by blood loss in older people?

Answer 22

colon cancer

Question 23

What are the two possible causes of haemolysis?

Answer 23

the problem is internal cell or external to the cell

Question 24

What are the three possible internal causes of haemolysis?

Answer 24

problem with the membrane, problem with the enzyme, problem with the Hb

Question 25

What is the most common cause of problems with the membrane in red blood cells?

Answer 25

hereditary spherocytosis

Question 26

What is the most common cause of problems with the enzymes?

Answer 26

G6PD deficiency

Question 27

What are the most common causes of problems with the haemoglobin?

Answer 27

sickle cell or thalassemia

Question 28

What are the 3 possible causes of haemolysis that is caused by an external cause?

Answer 28

immune mediated, mechanical or infection

Question 29

What are the mechanical causes of haemolysis?

Answer 29

sepsis, hardware (e.g. valve), haemolytic uremic syndrome, haemangioma

Question 30

What are the infectious causes of haemolysis?

Answer 30

malaria

Question 31

What are the three causes of failure of production of red blood cells?

Answer 31

haematinics, marrow failure or supression, marrow invasion

Question 32

Lack of which haematinics causes a macrocytic anaemia?

Answer 32

B12 and folate

Question 33

Lack of which haematinic causes a microcytic anaemia?

Answer 33

iron

Question 34

What is the differential diagnosis for microcytic anaemia?

Answer 34

iron deficiency or thalassemia

Question 35

What causes bone marrow invasion?

Answer 35

* Leukaemia * Solid tumour * Fibrosis * Metabolic/storage * infection

Question 36

What is the treatment for anaemia?

Answer 36

cause specific or if unknown cause transfusion will always work

Question 37

On which chromosome are the ABO genes?

Answer 37

chromosome 9

Question 38

On which chromosome is the H gene?

Answer 38

chromosome 19

Question 39

If your blood group is A what antigens are present on your red blood cells?

Answer 39

A and H

Question 40

If your blood group is B what antigens are present on your red blood cells?

Answer 40

B and H

Question 41

If your blood group is AB what antigens are present on your red blood cells?

Answer 41

A and B

Question 42

If your blood group is O what antigens are present on your red blood cells?

Answer 42

H

Question 43

What do the ABO genes do?

Answer 43

codes for transferase enzymes which adds sugars to the H precursor

Question 44

If your blood group is A what antibodies do you have?

Answer 44

B

Question 45

If your blood group is B what antibodies do you have?

Answer 45

A

Question 46

If your blood group is AB what antibodies do you have?

Answer 46

none

Question 47

If you blood group is O what antibodies do you have?

Answer 47

A and B

Question 48

What are the antigens of the Rhesus blood group system?

Answer 48

C, c, D, E and e

Question 49

What is rhesus positive?

Answer 49

positive for the D rhesus antigen

Question 50

What is rhesus negative?

Answer 50

negative for the D rhesus antigen

Question 51

On which chromosome are the rhesus antigens located?

Answer 51

chromosome 1

Question 52

Who has rhesus antibodies?

Answer 52

rhesus negative individuals who have been exposed to rhesus positive blood either through a tranfusion or pregnancy

Question 53

What blood group is the universal donor for red blood cells?

Answer 53

O

Question 54

What blood group is the universal donor for plasma?

Answer 54

AB

Question 55

What happens if you transfuses a rhesus negative patient with rhesus positive blood?

Answer 55

there will be a mild immune reaction 7-10 days later which is not fatal but if the patient is ever exposed to rhesus positive blood again there will be a fatal immune reaction

Question 56

What is haemolytic disease of the newborn and how is it prevented?

Answer 56

haemolytic disease of the newborn is where a rhesus negative mum has a rhesus positive fetus and furing the pregnancy or during birth the mum is exposed to the blood and amounts an immune response against it - during the next pregnancy the antibodies will cross from mum to the baby and attack the fetus' red blood cells - it is prevented by giving the mum anti D antibodies during pregnancy so that if there is any fetal blood in her circulation the antibodies will destroy them and this prevents the mum ammounting an immune response against them