Anaemia Flashcards

1
Q

What will Fe studies of a Fe deficit patient show?

A

Low ferritin

Low Transferrin saturation

Low Fe

Normal or high transferrin

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1
Q

How do you differentiate Fe deficiency anaemia and thalassemia minor on FBE?

A

For the same degree of microcytosis, the Hb concentration is spared and the cell count remains normal in thal minor cf to Fe deficiency

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2
Q

Why might a haemolysis not be picked up in FBE?

A

Because compensatory erythropoiesis is maintaining Hb

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3
Q

What are the five tests that are abnormal in haemolysis?

A

Blood film

Lactate dehydrogenase

Hyperbilirubinaemia (unconjugated)

Reticulocytosis

Depressed haptoglobins (to pick up the products of haemolysis)

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3
Q

Does finding no HbH in parents exclude thalassaemia major developing in children?

A

No, both may be aa/- - where HbH test is not sensitive enough

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3
Q

What are porphyrias?

A

Disorders of haem

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5
Q

Why do anaemia’s of inflammation develop?

A

Because inflammatory mediators depress EPO or elevate hepcidin

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6
Q

What is HbH?

A

Hb with a beta chain tetramer - no O2 carrying capacity but diagnostic of alpha thalassemia

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9
Q

What is the function of transferrin in Fe balance?

A

Transport Fe

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10
Q

What is the function of ferritin in Fe balance?

A

Store Fe

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11
Q

How will the blood film appear in B12 deficiency?

A

Macrocytic RBCs

Some ovular RBCs

Hypersegmented neutrophils

Cytopenia of other blood cell types

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12
Q

How does myelofibrosis cause anaemia?

A

Scar tissue replaces haematopoiesis

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13
Q

What is myelodysplasia?

A

Disorder or inefficient haematopoiesis

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14
Q

How does the anaemia caused by occult GIT bleed evolve over time?

A

Starts with normocytic anaemia then changes to microcytic, hypochromatic as Fe stores are depleted

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15
Q

What do anaemia’s of chronic disease show on Fe studies?

A

Transferrin is low

Ferritin is high

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16
Q

What are the board causes of haemolysis?

A

Intrinsic

  • Enzymatic eg G6PD deficiency
  • Membrane eg hereditory spirocytosis
  • Hb eg sickle cell

Extrinsic

  • Immune
  • Non-immune eg HUS, mechanical