Anaemia

Question 1

Describe the lineage of pleuripotent cells?

Answer 1

Pleuripotent blood stem cell -
Myloid - RBC, platelets, myoblasts
Lymphoid stem cell - lymphblast - WBC

Question 2

Where are blood cells produced?

Answer 2

Bone marrow

Question 3

What is anaemia?

Answer 3

A reduction in one or more of the major RBC measurements causeing a decrease in the 02 carrying capacity of the blood and less 02 delivery to tissues
(obtained as part of FBC)

Question 4

What is normal Hb levels?

Answer 4

130 -170 g/L M

120 - 150 g/L F

Question 5

What is Htc?

Answer 5

Haematocrit

The % of the cell volume occupied by cells

Question 6

Other than anaemia, when is Htc altered?

Answer 6

Acute bleed
Pregnancy - plasma volume increases in 3rd trimester so makes the Htc look comparatively low
Volume depletion - dehydration so Htc will look increase compared to plasma

Question 7

What are the symptoms of anaemia?

Answer 7

MUSCULOSKELETAL - fatigue, tired, cramps
NEUROLOGICAL - dizzy, faint, lack concentration, blurred vision, insomnia, irritable, depressed
CVS - angina, SOB, palpitations, intermittent claudication, heart failure

Question 8

What are the signs for anaemia?

Answer 8

pallor
increased HR
postural hypotension
cardiac failure
confusion

Question 9

What are common signs of 4 specific anaemias?

Answer 9

Koilonychia (iron deficient) - spoon nails
Jaundice (haemolytic) - high bilirubini as RBC breakdown
Leg ulcers (sickle cell)
Bone deformities (thalassaemia)

Question 10

What will show orally in an anaemic person?

Answer 10

Dry, smooth, red tongue
Angular chelitis
Ulcers
Candida

Question 11

What is anaemia MCV?

Answer 11

mean corpuscular volume

Question 12

What are the 3 types of anaemia MCV?

Answer 12

MICROCYTIC - small cell size due to ferritin deficiency or thallassaemia
NORMOCYTIC - due to haemorrhage or haemolytic
MACROCYTIC - megaloblastic - Vit 12 or folate deficiency, or non - megaloblastic - alcohol, liver disease, hypothyroidism, aplastic anaemia

Question 13

What causes ferritin deficiency anaemia?

Answer 13

1) poor diet
2) low iron absorption (in duodenum) - affected by coeliacs, gastritis)
3) high physiological demand - infancy, puberty, pregnant
4) high blood loss - haemorrhage, haematemesis, melaena, haemoptysis, haematuria

Question 14

What is common in ferritin deficient anaemia?

Answer 14

PICA
beeturia - 50% have red urine
Restless leg syndrome

Question 15

How would you investigate ferritin deficient anaemia?

Answer 15

OGD

Colonoscopy

Question 16

How would you treat ferritin deficient anaemia?

Answer 16

Treat underlying cause
Oral iron supplements
IV iron infusion

Question 17

What is Vit B12?

Answer 17

A water soluble vitamin found in foods of animal origin

Question 18

Where is Vit B12 absorbed?

Answer 18

Terminal ileum, but needs intrinsic factor to be absorbed

Question 19

Where is intrinsic factor produced?

Answer 19

Gastric parietal cells

Question 20

What causes Vit B12 deficieny?

Answer 20

Anything that decreases or damages parietal cells:
pernicious anaemia
gastrectomy
malabsorption (Crohns)

Question 21

What else is common in Vit B12 deficient anaemia?

Answer 21

Premature grey hair
Jaundice
Skin pigmentation
Neuropathy

Question 22

How would you treat Vit B12 deficient anaemia?

Answer 22

1mg hydroxycobalamin IM

Question 23

What is folate?

Answer 23

Found in leafy green veg but is destroyed by cooking

Question 24

What is the most common cause of folate deficient anaemia?

Answer 24

Dietary deficiency
Also:
alchohol
folic acid antagonists
malabsorption (Coeliacs)

Question 25

What is a lack of folate in pregnancy linked to?

Answer 25

Neural tube defects of the baby

Question 26

What is the treatment for folate deficient anaemia?

Answer 26

Treat underlying cause

DONT GIVE FOLATE SUPPLEMENTS WITHOUT KNOWING VIT B12 LEVELS

Question 27

What is the cause of thalassaemia?

Answer 27

Abnormalities of globin chain synthesis

Question 28

What is the cause of sickle cell anaemia?

Answer 28

Abnormalitis of globin chain structure

Question 29

What is the cause of haemolytic anaemia?

Answer 29

RBC breakdown