Anaemia

Question 0

what are the 3 main causes of anaemia?

Answer 0

blood loss
anaemia
impaired erythropoesis

Question 1

purpose of transferrin?

Answer 1

protein transport for iron

Question 2

purpose of ferritin?

Answer 2

iron storage protein

Question 3

ferritin levels can be misleading how?

Answer 3

if inflammation, could be elevated to look normal even though they’re really anaemic

Question 4

what is Hepcidin?

Answer 4

balances storage and release, related to innate immunity

Question 5

what is most common reason for iron deficiency WORLDWIDE? Australia?

Answer 5

hookworm

Aus: occult blood loss from PUD

Question 6

what’s important to look for in iron supplements?

Answer 6

50-60mg of elemental iron

Question 7

3 ways to take iron:

Answer 7

PO
IM
IV

Question 8

side effect of iron supplements?

Answer 8

constipation

Question 9

how does anaemia of inflammation happen?

Answer 9

elevated hepciden, decrease EPO

Question 10

how to differentiate iron deficiency vs. anaemia of chronic disease with lab results?

Answer 10

iron deficiency: lots of transferrin but no iron to transport
Anaemia of chronic: lots of ferritin but no transferrin to transport iron

Question 11

5 tests for haemolysis?

Answer 11

Abnormal blood film/morphology
hyperbilirubinaemia (unconjugated)
increased LDH
increased reticulocytes
depressed haptoglobins

Question 12

what does direct/indirect Coombs test do?

Answer 12

direct: tests for anti-red Ab bound to red cells
indirect: tests for free anti-red cell Abs

Question 13

what 2 things do you see in blood film with microangiopathy?

Answer 13

red cell fragments

schistocytes

Question 14

what 2 things you see in blood film with oxidative injury?

Answer 14

blister cells

bite cells

Question 15

how does urine look with haemolysis? why?

Answer 15

NOT DARK

cause of unconjugated bilirubin can’t cross glomeruli

Question 16

what pathway does G6PD deficiency affect? what is the other enzyme pathway called?

Answer 16

G6PD affects the pentose phosphate shunt

other: glycolytic

Question 17

what is jaundice without dark urine called?

Answer 17

acholuric

Question 18

what is aplastic anaemia?

Answer 18

empty bone marrow

Question 19

what is myelodysplasia?

Answer 19

disordered marrow, can’t produce

Question 20

body store of B12 is how long?

Answer 20

18 months

Question 21

B12 deficiency affects stomach how?

Answer 21

increased risk of Ca stomach

Question 22

what is myelofibrosis?

Answer 22

collagen in marrow

Question 23

difference between thalassaemia and porphyrias?

Answer 23

thalassaemia: globin chains
porphyrias: haem molecule

Question 24

3 kinds of haemoglobins and their chain numbers:

Answer 24

HbA: a2b2
HbF: a2y2
HbA2: a2d2

Question 25

how many gene copies of alpha chains vs. beta chains?

Answer 25

2 sets for alpha

1set for betas

Question 26

what is haemoglobin H?

Answer 26

beta-4 tetramers in alpha thallasaemia

Question 27

when do you get gamma-4 tetramers in blood?

Answer 27

fetus has alpha thal

Question 28

how to tell difference between thal minor and iron deficiency cause they’re both microcytic and hypochromic:

Answer 28

• in thal minor for same degree of microcytosis: Red Cell Count RCCis relatively spared
• red cell distribution is increased in iron deficiency

Question 29

what is HPLC? used for?

Answer 29

high performance liquid chromatography

to Dx thal or haemoglobinopathies

Question 31

danger of thinking HgH is enough to Dx which Alpha Thal someone has or risk to fetus?

Answer 31

mother and father with aa/– may not have lots of HgH but their unborn child has 1:4 chance for –/– thal major
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