Anaemia Flashcards
Which type of anaemia classically gives a ‘lemon yellow tinge’ to the skin?
Macrobiotic anaemic caused by Vitamin B12 deficiency, resulting in a combination of pallor and jaundice
List some causes of iron deficiency anaemia?
Bleeding e.g. menorrhagia, GI bleed
Malabsorption e.g. coeliac disease
Decreased dietary intake
Increased demand e.g. pregnancy
What is koilonychia?
Spoon-shaped nails
What will the FBC and iron studies show in a patient with iron deficiency anaemia?
Low Hb Low MCV Low MCH(C) Low ferritin (unless concurrent inflammation / malignancy as ferritin is an acute phase protein) High TIBC Low transferrin saturation Low serum iron
What is the pathophysiology of sideroblastic anaemia?
A cause of microcytic anaemia. There is defective harm synthesis as iron is deposited in the mitochondria of developing RBCs (erythroblasts) rather than in the haemoglobin molecule, so there is ineffective use of iron.
What is pernicious anaemia?
An autoimmune involving atrophic gastritis - there is infiltration of lymphocytes into the funds of the stomach causing destruction of parietal cells. Lack of parietal cells causes defective B12 absorption.
Where do humans get their Vitamin B12 from?
Dietary intake is from animal products (meat and dairy)
Where is Vitamin B12 absorbed?
Terminal ileum
With which carrier protein is Vitamin B12 transported to tissues after it has been absorbed?
Transcobalamin II
List some clinical features of Vit B12 deficiency
Anaemia symptoms
Neuropsychological symptoms - Depression, psychosis, dementia
Neurological - Parasthesiae, peripheral neuropathy
Subacute combined degeneration of the cord
What is the pathophysiology of hereditary spherocytosis?
This is a cause of inherited haemolytic anaemia and involves a problem with the red cell membrane. There is a defect in the membrane (usually due to a reduction in a protein called spectrin) which increases the cell’s permeability to sodium, causing spherically shaped red cells (spherocytes). These spherocytes are rigid and are destroyed prematurely in the spleen.
List 5 causes of inherited haemolytic anaemia
Membrane defect: Hereditory spherocytosis, hereditory elliptocytosis
Haemoglobin abnormality: Sickle cell disease, thalassemia
Enzyme abnormality: G6PD (glucose-6-phosphate dehydrogenase) deficiency
What is the inheritance pattern of hereditory spherocytosis?
Autosomal dominant
What type of antibodies are found in warm autoimmune haemolytic anaemia?
IgG
What type of antibodies are found in cold autoimmune haemolytic anaemia?
IgM
