Anaemia Flashcards
what are the 3 main causes of anaemia?
blood loss
anaemia
impaired erythropoesis
purpose of transferrin?
protein transport for iron
purpose of ferritin?
iron storage protein
ferritin levels can be misleading how?
if inflammation, could be elevated to look normal even though they’re really anaemic
what is Hepcidin?
balances storage and release, related to innate immunity
what is most common reason for iron deficiency WORLDWIDE? Australia?
hookworm
Aus: occult blood loss from PUD
what’s important to look for in iron supplements?
50-60mg of elemental iron
3 ways to take iron:
PO
IM
IV
side effect of iron supplements?
constipation
how does anaemia of inflammation happen?
elevated hepciden, decrease EPO
how to differentiate iron deficiency vs. anaemia of chronic disease with lab results?
iron deficiency: lots of transferrin but no iron to transport
Anaemia of chronic: lots of ferritin but no transferrin to transport iron
5 tests for haemolysis?
Abnormal blood film/morphology hyperbilirubinaemia (unconjugated) increased LDH increased reticulocytes depressed haptoglobins
what does direct/indirect Coombs test do?
direct: tests for anti-red Ab bound to red cells
indirect: tests for free anti-red cell Abs
what 2 things do you see in blood film with microangiopathy?
red cell fragments
schistocytes
what 2 things you see in blood film with oxidative injury?
blister cells
bite cells
how does urine look with haemolysis? why?
NOT DARK
cause of unconjugated bilirubin can’t cross glomeruli
what pathway does G6PD deficiency affect? what is the other enzyme pathway called?
G6PD affects the pentose phosphate shunt
other: glycolytic
what is jaundice without dark urine called?
acholuric
what is aplastic anaemia?
empty bone marrow
what is myelodysplasia?
disordered marrow, can’t produce
body store of B12 is how long?
18 months
B12 deficiency affects stomach how?
increased risk of Ca stomach
what is myelofibrosis?
collagen in marrow
difference between thalassaemia and porphyrias?
thalassaemia: globin chains
porphyrias: haem molecule
3 kinds of haemoglobins and their chain numbers:
HbA: a2b2
HbF: a2y2
HbA2: a2d2
how many gene copies of alpha chains vs. beta chains?
2 sets for alpha
1set for betas
what is haemoglobin H?
beta-4 tetramers in alpha thallasaemia
when do you get gamma-4 tetramers in blood?
fetus has alpha thal
how to tell difference between thal minor and iron deficiency cause they’re both microcytic and hypochromic:
- in thal minor for same degree of microcytosis: Red Cell Count RCCis relatively spared
- red cell distribution is increased in iron deficiency
what is HPLC? used for?
high performance liquid chromatography
to Dx thal or haemoglobinopathies
danger of thinking HgH is enough to Dx which Alpha Thal someone has or risk to fetus?
mother and father with aa/– may not have lots of HgH but their unborn child has 1:4 chance for –/– thal major
DO MOLECULAR STUDIES
