Anaemia

Question 1

PCV means the same as..

Answer 1

Hct

Question 2

Name 3 haematinics?

I.e. substances required for normal development of red cells

Answer 2

Iron
Vit B12
Folate

Question 3

Name 4 iron studies?

Answer 3

Serum ferritin
Serium iron
TIBC (total iron binding capacity)
Transferrin

Question 4

Anaemia symptoms?

Answer 4

Tiredness/fatigue/lassitude/drowsiness 
Headache
Weakness
Light headedness/dizziness/vertigo 
Fainting
Breathlessness on exertion 
Palpitations
Worsening ischaemic symptoms e.g: Angina, Intermittent claudication 
Menstrual disturbance

Question 5

Non-specific signs of anaemia?

Answer 5

Pallor
Pale conjunctiva
Pale palmar creases
Tachycardia
Postural hypotension
Signs of congestive heart failure e.g. ankle swelling Murmur

Question 6

Signs of Fe def anaemia?

Answer 6

Brittle nails and koilonychia
Brittle hair
Angular stomatitis
Glossitis (redness of the tongue and loss of papillae)

Question 7

Signs of B12 def anaemia?

Answer 7

Angular stomatitis

Glossitis (redness of the tongue and loss of papillae)

Question 8

Signs of haemolytic anaemia

Answer 8

Jaundice

As destruction > production

Question 9

Signs of sickle cell disease

Answer 9

Leg ulcers

Question 10

Signs of thalassaemia major

Answer 10

Bone deformities

Question 11

Lifespan of RBC?

Answer 11

120 days (require 1% renew`al per day)

Question 12

Name 5 of the main causes of anaemia?

Answer 12

1. Blood loss
2. Nutrient deficiency or malabsorption e.g. iron (due to hookworm inf), vit b12, folate, malnutrition
3. Chronic system disease e.g. anaemia or chronic disease, kidney/liver/thyroid disease
4. Immune disease e.g. autoimmune haemolytic anaemia, transfusion reactions (ABO incompatibility)
5. Infections e.g. CMV, malaria

Question 13

Risk factors for iron deficiency anaemia?

Answer 13

Female
Extremes of age
Lactation
Pregnancy
Poverty

Question 14

4 causes of microcytic anaemia?

Answer 14

Chronic blood loss
Low iron stores
Thalassaemia
Lead poisoning

Question 15

Causes of normocytic anaemia?

Answer 15

Acute blood loss
Endocrine disease
Combined deficiency

Question 16

Causes of high macrocytic anaemia?

Answer 16

Megaloblastic anaemias (pernicious anaemia, nutritional deficiency anaemia of folic acid and vit b12)
Drugs
Liver disease (e.g. alcohol abuse)

Question 17

What is meant by megalobasltic anaemia?

Answer 17

Anaemia due to nutrient deficiency e.g.

• Fe def
• Folate
• Vit B12

Fe def gives a microcytic picture
Folate and vit b12 are macrocytic due to arrested of erythroblasts DNA development.

Question 18

What is meant by pernicious anaemia?

Answer 18

Specific autoimmune disorder –> Gastric mucosa atrophy + IF deficiency –> Low B12 uptake

Other indicators:

• Parietal cell antibodies
• IF antibodies
• Other autoimmune disorders such as hypothyroidism

Question 19

Difference between menorrhagia and menometrorrhagia?

Answer 19

Menorrhagia is abnormally heavy and prolonged menstrual periods at regular intervals. Menometrorrhagia is prolonged or excessive bleeding occurring irregularly and more frequently than normal.

Question 20

What type of anaemia does chronic blood loss lead to?

Answer 20

Chronic blood loss leads to on-going iron loss and produces a microcytic hypochromic anaemia due to eventual iron deficiency. The red cells are small pale and hypochromic due to lack of iron. There is often an increase in platelet count (thrombocytosis) as a result of a reactive increase in bone marrow activity.

Question 21

What is transferrin?

High level indicates…

Answer 21

Protein which transports iron

High in Fe deficient anaemia (so when Fe stores are low)

Question 22

Difference in the anaemic response in acute and chronic blood loss?

Answer 22

In acute haemorrhage there is a rapid development of a normocytic normochromic anaemia with a reactive increase in reticulocytes (reticulocytosis) within 6 hours.
In chronic gradual blood loss there is a gradual development of a microcytic hypochromic anaemia with or without a low serum ferritin due to low storage levels of iron. (Iron stores are used up replacing the lost red blood cells.) There is a reactive increase in the platelet count (thrombocytosis.)

Question 23

Inherited haemolytic anaemia?

Answer 23

Sickle cell disease

Question 24

Excessive haemoysis leads to..

Answer 24

 unconjugated bilirubin in the blood and consequently jaundice
 urinary urobilinogen (product of bilirubin breakdown)
 LDH in blood (lactate dehydrogenase released from the cells)
 reticulocytosis (due to bone marrow compensation)

Question 25

MCH is ranked as..

Answer 25

hypo-
normo-
hyper-

“chromic” i.e. the mass of haemoglobin

Question 26

Anaemia of chronic disease causes a _____ ________ anaemia

Answer 26

naemia of chronic disease causes a normocytic normochromic anaemia