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Haematology > Anaemia > Flashcards

Anaemia Flashcards

1
Q

What colour do reticulocytes stain?

A

deep red/purple

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2
Q

If MCV low (microcytic) what should be considered as the problem?

A

haemoglobinisation - Cytoplasm defect

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3
Q

If MCV high (macrocytic) what should be considered as the problem?

A

maturation

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4
Q

In which type of anaemia are the RBCs hypochromic (lacking in colour)?

A

Microcytic

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5
Q

2 main types of microcytic anaemia?

A 
iron deficiency
globin deficiency (thalassemia)
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6
Q

What 2 things is iron essential for?

A

O2 transport

Electron transport

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7
Q

In what way is iron potentially toxic to the body?

A

produces free radicals

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8
Q

Describe the structure of adult haemoglobin.

A

4 globulin molecules (2 alpha, 2 beta)

I haem subunit attached, which contains an iron ion (Fe2+)

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9
Q

How many O2 molecules can one haem group bind to?

A

1

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10
Q

Where is most of the iron in the body?

A

in the haemoglobin

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11
Q

Is the iron cycle an open or closed system?

A

closed

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12
Q

Is the iron turnover in the plasma pool fast or slow?

A

fast

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13
Q

Circulating iron is bound to what?

A

transferrin

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14
Q

Where is iron transferred to?

A

bone marrow macrophages, which feed it to the red cell precursors

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15
Q

Where is iron mainly stored as ferritin?

A

liver

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16
Q

What is the name of the protein which has two binding sites for iron?

A

transferrin

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17
Q

In what situation is transferrin increased?

A

genetic haeomochromatosis

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18
Q

What does low ferritin mean?

A

iron deficiency

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19
Q

3 general caused of iron deficiency?

A

not getting enough iron i.e. diet
losing it through bleeding
not absorbing it

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20
Q

Examples of malabsorption of iron?

A

coeliac disease

Achlorydia (absence of HCl in gastric secretions)

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21
Q

What are the two general causes of macrocytic anaemia?

A

genuine (megaloblastic/nonmegaloblastic)

spurious

22
Q

What is an erythroblast?

A

Erythroblast: A normal red cell precursor with a nucleus

23
Q

What is a megaloblast?

A

An abnormally large nucleated red cell precursor with an immature nucleus.

24
Q

Megaloblastic anaemias are characterised by what?

A

defects in DNA synthesis and nuclear maturation

25
Q

What happens to RNA and haemoglobin synthesis in megaloblastic anaemias?

A

relative preservation of RNA and haemoglobin synthesis

26
Q

The larger cell size in megaloblastic anaemia is not due to an increase in the size of the developing cell, but what?

A

a failure to become smaller

27
Q

Causes of Megaloblastic Anaemia?

A 
B12 deficiency
Folate deficiency
Others
Drugs
Rare inherited abnormalities
28
Q

Why does lack of B12 or folate cause megaloblastic anaemia?

A

B12 and folate are essential co-factors for nuclear maturation. They enable chemical reactions that provide enough nucleosides for DNA synthesis

29
Q

Are B12 and folate biochemical reactions interlinked?

A

yes - Methionine cycle and folate cycle

30
Q

Dietary folates are converted to what, and absorbed where?

A

monoglutamate, absorbed in jejenum

31
Q

Give 4 causes of folate deficiency.

A
  • drugs
  • malabsorption
  • excess utilization
  • inadequate intake
32
Q

List symptoms of folate and B12 deficiency which are common to both.

A

Symptoms/signs of anaemia
weight loss, diarrhoea, infertility
Sore tongue, jaundice
Developmental problems

33
Q

In which deficiency may problems occur to myelin sheath?

A

b12

34
Q

Name the autoimmune condition with resulting destruction of gastric parietal cells.

A

Pernicious anaemia

35
Q

Give an example of some autoimmune conditions which pernicious anaemia may be associated with.

A

Hypothyroidism, vitiligo, Addison’s disease

36
Q

Blood film shows what in pernicious anaemia?

A

macrovalocytes and hypersegmented neutrophils

37
Q

Is pernicious anaemia micro or macro?

A

macrocytic, and there may be pancytopenia

38
Q

Are Assay B12 and folate levels in serum always reliable?

A

no

39
Q

Which antibodies are tested for in B12 and folate defiency?

A

anti gastric-parietal cell (GPC) and anti-intrinsic factor (IF)

40
Q

Is bone marrow examination usually required for b12/folate deficiency?

A

no

41
Q

Treatment for pernicious anaemia?

A

vitamin b12 injections for life

42
Q

In what type of anaemia would red blood cell transfusion be given?

A

life threatening

43
Q

Causes of non megaloblastic macrocytosis?

A

Alcohol
Liver disease
Hypothyroidism
Marrow failure (this is the only one of the 4 which is most likely to be ass. with anaemia)

44
Q

Two types of spurious macrocytosis?

A

Reticulocytosis

Cold agglutinins disease

45
Q

What does reticulocytosis indicate?

A

indicates a marrow response to ‘loss’ of red cells either through acute bleeding or haemolysis

46
Q

What happens in Cold Agglutinins disease?

A

“analyser” gets confused as clumps of ‘agglutinated’ red cells go through and are registered as 1 big cell

47
Q

Why may patients with pernicious anaemia appear mildly jaundiced?

A

intramedullary haemolysis

48
Q

What does this describe:
Red cells die prematurely in the marrow
Haemoglobin and lactate dehydrogenase (LDH) are released from dead red cells
Haemoglobin converted to bilirubin

A

ineffective erythropoiesis

49
Q

What can complicate severe megaloblastic anaemia?

A

pancytopenia

50
Q

Can nuclear maturation defects affect all lineages?

A

yes

51
Q

What is the most useful classification of anaemia?

A

MCV

Haematology (17 decks)

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