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Exam Questions > Anaemia > Flashcards

Anaemia Flashcards

1
Q

Causes of anaemia

A
  • Increased plasma volume (pregnancy)
  • Increased loss of RBCs
  • Decreased production of RBCs
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2
Q

Symptoms of anaemia

A
  • Fatigue
  • Tinnitus
  • Dyspnoea
  • Faintness
  • Palpitations
  • Angina (pre-existing coronary artery disease)
  • Headache
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3
Q

Signs of anaemia

A
  • Pallor (conjunctiva)
  • Tachycardia
  • Ejection systolic murmur
  • Cardiac enlargement
  • Retinal haemorrhage
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4
Q

3 types of microcytic anaemias

A
  • Iron deficiency
  • Thalassemia (high serum iron + ferritin)
  • Sideroblastic anaemia (very rare) (high serum iron + ferritin)
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5
Q

5 causes of normocytic anaemia

A
  • Acute blood loss
  • Anaemia of chronic disease
  • Bone marrow failure
  • Haemolysis
  • Pregnancy
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6
Q

When to suspect marrow failure

A
  • Low platelet + WCC

- ?Normocytic anaemia?

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7
Q

5 Causes of macrocytic anaemia

A
  • B12 or folate deficiency
  • Alcohol excess or liver disease
  • Myelodysplastic syndromes
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8
Q

Causes of iron deficiency anaemia

A
  • Blood loss (menorrhagia or GI bleeding)
  • Malabsorption, coeliac disease
  • Poor diet in children, unlikely in adults
  • Hook worms, in the tropics (GI blood loss)
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9
Q

Signs of IDA

A
  • Angular stomatitis
  • Koilonychia
  • Atrophic glossitis
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10
Q

What type of anaemia is IDA

A

Microcytic Hypochromic

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11
Q

Investigations for IDA

A
  • Serum ferritin (?+serum iron?)
  • Blood film
  • Stool microscopy for ova (if hookworm suspected)
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12
Q

Rx of IDA

A
  • Rx cause (menorrhagia COCP)

- Oral iron (ferrous sulphate)

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13
Q

Cause anaemia of the chronic disease (secondary anaemia)

A

Many

  • Chronic infection
  • Vasculitis
  • Rheumatoid arthritis
  • Malignancy
  • Renal failure
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14
Q

Pathophysiology of secondary anaemia

A
  • Poor use of iron in erythropoiesis
  • Cytokine-induced shortening of RBC survival
  • Reduced production of +response to erythropoietin
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15
Q

Investigations for secondary anaemia

A
  • Blood film
  • B12, folate and TSH levels
  • Bilirubin?
  • Serum LDH (Lactic dehydrogenase)?
  • Coomb’s test?
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16
Q

Rx for secondary anaemia

A
  • Rx underlying cause
  • Erythropoietin
  • Parenteral Iron
17
Q

Causes macrocytosis

A
  • Megaloblastic
  • Non-Megaloblastic
  • Other haematological disease
18
Q

Most common type of macrocytic anaemia

A

Pernicious anaemia (Vit B12 deficiency)

19
Q

Causes of Megaloblastic anaemia

A
  • B12 deficiency
  • Folate deficiency
  • Cytotoxic drugs
20
Q

Causes of non-Megaloblastic anaemia

A
  • Alcohol excess, liver disease
  • Hypothyroidism
  • Pregnancy
21
Q

Investigations of macrocytic anaemia

A
  • Blood film
  • Serum B12 and folate
  • Bone marrow biopsy
  • LFTs
22
Q

Causes of folate deficiency

A

-Poor diet, alcoholics
-Increased demand (pregnancy, malignancy etc)
-Malabsorption (coeliac disease)
-Drugs
Phenytoin
Methotrexate
Sodium valproate
Trimethoprim

23
Q

Rx for folate deficiency

A
  • Rx underlying cause

- Folic acid 5mg/d po

24
Q

How do we absorb Vit B12

A

Binds to intrinsic factor, absorbed at terminal ileum

25
Q

Why does Vit B12 deficiency cause anaemia

A
  • Reduced synthesis of thymine
  • Therefore reduced DNA synthesis
  • Therefore reduced RBCs synthesis
26
Q

Causes of Vit B12 deficiency

A
  • Dietary (vegans)
  • Malabsorption
  • Congenital metabolic errors
27
Q

Why may there be malabsorption of Vit B12

A
  • Gastrectomy (lack of intrinsic factor)
  • Ileal resection
  • Crohn’s disease
28
Q

Symptoms of pernicious anaemia

A
  • General anaemia symptoms
  • Lemon skin (due to pallor + mild jaundice)
  • Angular stomatitis
  • Glossitis
  • Dementia
  • Degeneration of spinal cord
29
Q

Cause of pernicious anaemia

A
  • Autoimmune atrophic gastritis

- Leads to lack of gastric intrinsic factor excretion

30
Q

Investigations for pernicious anaemia

A
  • FBC
  • Serum B12
  • Blood film
  • Parietal cell antibodies
31
Q

What makes intrinsic factor

A

Parietal cells

32
Q

Rx for pernicious anaemia

A
  • Rx cause if possible
  • If due to malabsorption then B12 injection are required
  • If cause is dietary then oral B12 can be given

Exam Questions (21 decks)

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