Anaemia Flashcards
Describe the lineage of pleuripotent cells?
Pleuripotent blood stem cell -
Myloid - RBC, platelets, myoblasts
Lymphoid stem cell - lymphblast - WBC
Where are blood cells produced?
Bone marrow
What is anaemia?
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)
What is normal Hb levels?
130 -170 g/L M
120 - 150 g/L F
What is Htc?
Haematocrit
The % of the cell volume occupied by cells
Other than anaemia, when is Htc altered?
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
What are the symptoms of anaemia?
MUSCULOSKELETAL - fatigue, tired, cramps
NEUROLOGICAL - dizzy, faint, lack concentration, blurred vision, insomnia, irritable, depressed
CVS - angina, SOB, palpitations, intermittent claudication, heart failure
What are the signs for anaemia?
pallor increased HR postural hypotension cardiac failure confusion
What are common signs of 4 specific anaemias?
Koilonychia (iron deficient) - spoon nails Jaundice (haemolytic) - high bilirubini as RBC breakdown Leg ulcers (sickle cell) Bone deformities (thalassaemia)
What will show orally in an anaemic person?
Dry, smooth, red tongue
Angular chelitis
Ulcers
Candida
What is anaemia MCV?
mean corpuscular volume
What are the 3 types of anaemia MCV?
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
What causes ferritin deficiency anaemia?
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
What is common in ferritin deficient anaemia?
PICA
beeturia - 50% have red urine
Restless leg syndrome
How would you investigate ferritin deficient anaemia?
OGD
Colonoscopy
How would you treat ferritin deficient anaemia?
Treat underlying cause
Oral iron supplements
IV iron infusion
What is Vit B12?
A water soluble vitamin found in foods of animal origin
Where is Vit B12 absorbed?
Terminal ileum, but needs intrinsic factor to be absorbed
Where is intrinsic factor produced?
Gastric parietal cells
What causes Vit B12 deficieny?
Anything that decreases or damages parietal cells:
pernicious anaemia
gastrectomy
malabsorption (Crohns)
What else is common in Vit B12 deficient anaemia?
Premature grey hair
Jaundice
Skin pigmentation
Neuropathy
How would you treat Vit B12 deficient anaemia?
1mg hydroxycobalamin IM
What is folate?
Found in leafy green veg but is destroyed by cooking
What is the most common cause of folate deficient anaemia?
Dietary deficiency Also: alchohol folic acid antagonists malabsorption (Coeliacs)
What is a lack of folate in pregnancy linked to?
Neural tube defects of the baby
What is the treatment for folate deficient anaemia?
Treat underlying cause
DONT GIVE FOLATE SUPPLEMENTS WITHOUT KNOWING VIT B12 LEVELS
What is the cause of thalassaemia?
Abnormalities of globin chain synthesis
What is the cause of sickle cell anaemia?
Abnormalitis of globin chain structure
What is the cause of haemolytic anaemia?
RBC breakdown
