Anaemia Flashcards
when does anaemia occur?
when haemoglobin levels fall below the recommended rates.
what are the recommended rates for men?
130g/L
what are the recommended rates for females?
120g/L
what are the 3 types of anaemia?
microcytic, normocytic, macrocytic,
what is microcytic anaemia?
small cell size
normocytic anaemia?
normal cell size
macrocytic anaemia?
large cell size.
mean cell/corpuscular volume? mcv
average volume of red blood cell.
haematocrit? hct
volume percentage of red blood cells in blood. 45%.
mean corpuscular haemoglobin? mch
average amount og haemoglobin per red cell.
mean corpuscular haemoglobin concentration? mchc
average amount of haemoglobin per unit volume of red blood cells
red cell distribution width? rdw
variation in cell volume.
why does anaemia occur?
- there is something wrong with production of rbc
- there is deficiency in material to make red blood cells
- there is abnormal loss/breakdown of red blood cells.
features of hypochromic microcytic anaemia?
- mcv lower than 80.
- production of red blood cells is smaller than usual.
- decreased haemoglobin production.
what are causes of microcytic anaemia?
S - sideroblastic anaemia
L - lead poisoning
I - iron deficiency (most common) (high rdw)(more variation in size of rbc)
T - thalassemia (normal rdw) (less variration in rbc size)
what do microcytic anaemia cells look like?
target shaped.
What is thalassemia?
genetic disease of haemoglobin synthesis.
- the alpha and beta chains of haemoglobin do not form properly
- abnormal production of haemoglobin protein
alpha?
?
beta?
?
what is hepcidin?
iron regulated acute phase protein.
what do increased hepcidin levels lead to?
decreased iron absorption.
what synthesises and secreted hepcidin?
liver.
what is ferritin?
iron stored.
what happens when ferritin is high?
a lot of iron stored in the body.
what is transferrin?
a molecule that transports iron.
features of normochromic macrocytic anaemia?
mcv greater than 100
what are the causes of macrocytic anaemia?
FATRBC.
F - foetus (poor folate absorption during preg)
A - alcohol (which may lead to B12/folate deficiency)
T - Thyroid.
R - Reticulocytosis (when there are anormal RBC precursors)
B - B12/folate deficiency.
C - cirrhosis (liver)
when does megaloblastic normochromic macrocytic anaemia occur?
when there are direct DNA problems, leading to production of ineffective/mutated RBC.
why may megaloblastic normochromic macrocytic anaemia occur?
- due to b12/folate deficiency.
- particular drugs (antiviral drugs that mess up folate synthesis pathways)
what is non-megaloblastic normochromic macrocytic anaemia?
- macrocytic anaemia not caused by DNA damage.
- could be bone marrow issues, thyroid problems, cancer FATRBC
what is normochromic normocytic anaemia?
mcv between 80 and 100.
what can normochromic normocyti anaemia be caused by?
-anything that doesn’t cause microcytiv/macrocytic anaemia (blood loss, haemolysis, anaemia of chronic disease, bone marrow problems.)
what is the most common type of normocytic anaemia?
-haemolytic anaemia.
what does haemolysis reuslt in?
drop in hb, but no change in size of rbc.
what would happen to ldh in haemolytic anaemia?
increase.
what would happen to haptoglobin in haemolytic anaemia?
decrease
what would happen to bilirubin in haemolytic anaemia?
increase
what is bilirubin?
yellow toxic substance insdie tbc that is released when cells lyse. increased bilirubin causes jaundice.
what tests happen in haemolytic screen?
LDH Haptoglobin bilirubin reticulocyte testing blood films coombs/DAT test- antibodies.
what are reticulocytes?
precursors to rbc
how are reticulocyte levels used?
if problems with rbc/anaemia/blood loss/lysis occur:
- increased reticulocyte levels mean the bone marrow is working healthily as it is producing more rbc to make up for loss.
- decreased reticulocyte levels indicate there is an issue with bone marrow.
what is hepcidin inhibited/induced by?
lipopolysaccharides and IL6
