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Haematology > Anaemia > Flashcards

Anaemia Flashcards

1
Q

Type of anaemia in chronic disease

A

Normocytic

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2
Q

Anaemia in renal failure

A

Normocytic

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3
Q

Anaemia in pregnancy

A

Normocytic

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4
Q

Anaemia in liver disease

A

Macrocytic

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5
Q

Anaemia if marrow infiltration

A

Macrocytic

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6
Q

Haemolytic anaemia signs

A

Mild macrocytic, reticulocytosis, raised Urobilinogen and bilirubin
But not bilirubin in urine as haemolysis causes pre-hepatic jaundice therefore it is Unconjugated and still bound to albumin therefore can’t do into urine

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7
Q

What Hb level do you consider blood transfusion?

A

under 8

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8
Q

How do you treat someone with severe anaemia and heart failure?

A

Packed cells given slowly because don’t want to fluid overload
Also give 10-40mg furosemide

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9
Q

What happens to circulation in severe anaemia -

A

Hyper dynamic
Tachycardia
Flow murmurs
Cardiac enlargement

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10
Q

Treatment of iron deficiency anaemia and aim

How long to continue therapy for

A

200mg/8hr of ferrous sulphate
Aim to increase Hb by 10g/L/week
Continue until normal and for at least 3 months to replenish stores

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11
Q

Side effects of ferrous sulphate

A 
Nausea 
Abdominal discomfort 
Diarrhoea
Constipation
Black stools
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12
Q

Main reason for IDA failing to respond to iron replacement

A

Patient has rejected pills therefore concordance issues

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13
Q

Treatment in anaemia of chronic disease

A

Erythropoietin can raise haemoglobin level

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14
Q

Side effects of erythropoietin

A

Hypertension, flu-like symptoms, mild rise in platelet count and thromboembolism

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15
Q

Microcytic anaemia not responding to iron

A

Think maybe sideroblastic anaemia

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16
Q

White cell count in viral infection

A

Neutropenia
But lymphocytosis
Basophilia

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17
Q

Effect of steroids on white cell count

A

Neutrophilia
But
Lymphopenia

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18
Q

Neutrophils in stress such as trauma, burns and haemorrhage

A

Neutrophilia

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19
Q

When are eosinophils raised?

A 
Drug reactions
Allergies
Parasitic infections
Skin disease 
Also seen in malignant disease
20
Q

Macrocytosis (non-megaloblastic) often without accompanying anaemia

A

Alcohol excess

21
Q

How do you measure folate levels

A

Red cell folate may be better than serum folate because serum folate only reflects recent intake

22
Q

Treatment of folate acid deficiency - accompanying medication

A

Folic acid 5mg/day for 4 months
Never without b12 (hydroxocobalamin)
unless known to have normal b12 level because can worsen subacute degeneration of the spinal cord

23
Q

Neurology in b12 deficiency

A

Subacute combined degeneration of the spinal cord - dorsal column loss (sensory and LMN signs) and symmetrical corticospinal tract loss (causons motor and UMN signs)

Joint position and vibration sense often lost first -ataxia first followed by stiffness and weakness if untreated

Classic triad: extensor planters, absent knee and absent ankle jerks

Spinothalamic never affected - therefore pain and temp maintained until end

24
Q

Treatment of pernicious anaemia

A

IM 1mg hydroxocobalamin for about 2 weeks to replenish stores
Maintenance dose of 1mg IM every 3 months for life

25
Q

Signs of extravascular haemolysis

A

Splenic hypertrophy and splenomegaly

26
Q

Signs of intervascular haemolysis

A

Methaemaalbuminaemia - Hb is broken down in circulation to produce haem and globin and haem combines with albumin

Haemoglobinuria - red-brown urine
Haemosiderinuria - when haptoglobin-binding capacity is reached

27
Q

Schistocytes on blood film

A

Microangiopathic haemolytic anaemia

28
Q

Heinz bodies on blood film or bite cells

A

g6p dehydrogenase deficiency

29
Q

Rapid anaemia and jaundice

A

G6p dehydrogenase deficiency

30
Q

Globin chain affected in sickle cell

A

Beta globin chain

31
Q

Triggers of sickle cell crisis

A

Cold, dehydration, infection or hypoxia

32
Q

When are sickle cell trait patients affected

A

Hypoxia

Unpressurised aircraft or anaesthesia

33
Q

Cells on blood film in sickle cell x2

A

Sickle cells and target cells

34
Q

GIT in sickle cell

A

CAn get mesenteric ischaemia due to occlusion - mimics acute abdomen

35
Q

What causes aplastic crisis in sickle and what is it?

A

Parvovirus b19
Sudden reduction in marrow production
Especially red blood cells

36
Q

Medication in sickle cell

A

Hydroxycarbamide - chemotherapy - increase hbF and can help

Given if frequent crises

37
Q

Management of sickle cell crisis

A

Prompt generous analgesia - IV opiates
Rehydrate
Keep warm
Blind antibiotics if fever, unwell or chest signs eg. Cephalosporin

38
Q

What is cooleys anaemia?

A

B thalassemia major

39
Q

Presentation of beta thalassemia major

A

Failure to thrive and severe anaemia in first year of life
Skull bossing (extra medullary harmopoiesis)
Hepatosplenomegaly

40
Q

Treatment of beta thal major and complication

A

Life long blood transfusions leading to iron overload/deposition - endocrine failure after 10 years, liver disease and cardiac toxicity

41
Q

Medication in beta thal major

A

Iron chelators

Deferiprone and desferrioxamine

42
Q

Why give ascorbic acid in beta thal maj

A

Increases urinary excretion of iron

43
Q

Beta thal intermedia

A

Moderate anaemia - doesn’t need transfusions

May be splenomegaly

44
Q

Alpha thalassemia with 3 deletions

A

HbH disease
Moderate anaemia and features of haemolysis (leg ulcers, hepatosplenomegaly and jaundice)
B4 tetramers in blood film

45
Q

Alpha thal with 2 deletions and 1 deletion

A

Asymptomatic carrier state with microcytic anaemia

1 - normal clinical state

Haematology (6 decks)

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