Anaemia

Question 1

What is anaemia

Answer 1

Hb concentration lower than the normal range

Question 2

What are clinical signs of anaemia

Answer 2

Pallor

Tachycardia

Systolic murmur

Hypotension

Question 3

Why may anaemia develop - overview of the causes

Answer 3

Abnormal erythropoiesis

Abnormal Hb synthesis

Abnormal RBC function

Abnormal RBC structure

Abnormal RBC metabolism

Excessive blood loss

Abnormal function of the reticuloendothelial system

Question 4

Name thre three sizes anaemia can be classified as and give examples of each

Answer 4

Macrocytic

• B12 or folate deficiency
• Liver disease
• Alcohol excess
• Haemolytic anaemias

Microcytic

• Iron deficiency
• Thalassaemia

Normocytic

• Sickle cell disease
• Early iron deficiency
• Anaemia of chronic disease
• Blood loss

Question 5

How are anaemias described by recticulocytes

Answer 5

High reticulocytes

Low reticulocytes

• High MCV
• Normal MCV
• Low MCV

Question 6

What does megaloblastic anaemia cause and what do the cells look like

Answer 6

Commonly causes macrocytic anaemia

The erythrocytes are larger than noraml and show oval morphology

Question 7

Name causes of macrocytic anaemia

Answer 7

B12 and/or folate deficiency

Chronic excess alcohol consumption

Liver disease

Hypothyroidism

Haemolytic anaemia

Myelodysplasia

Question 8

Causes of microcytic anaemia

Answer 8

Thalassaemia trait

Anaemia of chronic disease

Iron deficiency

Lead poisoning

Sideroblastic anaemia

Question 9

Types and causes of anaemia with a low reticulocyte count and normal MCV

Answer 9

Primary bone marrow failure - aplastic anaemia, red cell aplasia

Secondary bone marrow failure - anaemia of chronic disease, combined haemotinic deficiencies, uraemia, endocrine abnormalities, HIV

Question 10

Causes of anaemia with reticulocytosis

Answer 10

Acute blood loss

Splenic sequestration

Haemolysis

• Immune mediated
• Non-immune mediated
  
  • Mechanical
  • Haemoglobinopathies
  • Eznyme or membrane defects