Anaemia Flashcards
What are the different types of microcytic anaemia?
Iron deficiency anaemia
Anaemia of chronic disease (can be normochromic)
Sideroblastic anaemia
Thalassaemia
What are the causes of iron deficiency anaemia?
Excessive blood loss - GI and menstruation Dietary inadequacy - meat and green veg Reduced absorption - tetracyclines and quinolones - antacids and PPIs - gastrectomy -helicobacter pylori - coeliac - polyphenols, phytate and calcium - vit c increases iron absorption
What are the causes of anaemia of chronic disease?
infection
inflammation
cancer
What are the causes of sideroblastic anaemia?
congenital - x linked
acquired - bone marrow disease
Symptoms of iron deficiency anaemia?
brittle hair and nails hair loss koilonychia atrophic glossitis angular stomatitis fatigue pica - weird cravings
Symptoms of chronic disease anaemia?
new onset tiredness/palor/breathlessness/ tachcardia
no history of bleeding
What are the symptoms of sideroblastic anaemia?
iron overload signs of cytopaenia: anaemia infection bruising haemorrhage
What are the results of FBC for iron deficiency anaemia?
microcytic hypochromic pencil red cells reduced reticulocytes reduced serum iron reduced serum ferritin increased total iron binding capacity
What are the FBC results for anaemia of chronic disease ?
microcytic hypochromic/normochromic possible increase WBCs possible increase in platelets reduced transferrin saturation increased serum ferritin
What are the results and investigations for sideroblastic anaemia?
FBC - microcytic
Bone marrow - ring sideroblasts and generalised increase in iron stores
What is the management of iron deficiency anaemia?
oral iron - ferrous sulphate
S/E - constipation
treat underlying cause
What is the management of anaemia of chronic disease?
treat underlying cause
What is the management of sideroblastic anaemia?
supportive
red cell transfusion
iron chelation - desferrioxamine
avoid alcohol and vitamin c
recombinant EPO and granulocyte colony-stimulant
How many genes are there for alpha thalassaemia and on which chromosome?
2
chromosome 16
How many genes are there for beta thalassaemia and on which chromosome?
1
chromosome 11
What is the normal genotype for the BHb molecule?
B2/B2
What is the genotype and symptoms of B thalassaemia trait?
-/B2 slightly anaemic clinically asymptomatic Hypochromic microcytic
What is the genotype and symptoms of B thalassaemia intermedia?
-/Bo or B+/B+ anaemic very microcytic and Hypochromic symptomatic when Hb <7 g/dL splenomegaly variable bone changes variable transfusion dependency
What is the genotype and symptoms of B thalassaemia major?
-o/-o HbF >90% severe haemolytic anaemia very microcytic and Hypochromic hepatosplenomegaly chronic transfusion dependency
What is the normal genotype for the aHb molecule?
aa/aa
What is the genotype and symptoms of a thalassaemia heterozygous?
a,-/aa
borderline Hb, MCV
hypochromic
clinically asymptomatic
What is the genotype and symptoms of a thalassaemia homozygous?
aa/a- slightly anaemic microcytic hypochromic clinically asymptomatic
What is the genotype and symptoms of ao thalassaemia heterozygous?
aa/–
slightly anaemic
Hypochromic and microcytic
clinically asymptomatic
What is the genotype and signs of HbH disease?
a-/-- anaemic very microcytic and Hypochromic splenomegaly variable bone changes
What is the genotype and signs for a thalassaemia major?
–/–
Hb bart’s
haemolytic anaemia
fatal
What are the causes of normocytic normochromic anaemia?
chronic disease
blood loss
hypothyroidism
What are the causes of macrocytic anaemia?
B12/folate deficiency - vegans
cytotoxic drugs - azathioprine (kidneys and rheumatoid arthritis), cyclophosphamide (cancer and kid kidneys)
myelodypslasia (immature blood cell cancer)
haemolytic anaemias
hypothyroidism
liver disease and alcohol abuse - macrocytosis
what are the acute S/E of blood transfusion?
anaphylaxis
febrile
heart failure
infection - CMV, HIV
What are the side effects of a massive blood transfusion?
haemostatic failure - calcium and clotting
electrolyte disturbances - hypoccalcaemia, kyperkalaemia
what are the S/E of multiple blood transfusion?
platelet sensitisation
iron overload - desferrioxamine to treat
What is the difference between thrombocytopenia and thrombocytosis?
penia - not enough platelets
cytosis - too many platelets
How do you distinguish between iron deficiency anaemia and anaemia of chronic disease (microcytic)?
iron - low ferritin
disease - normal or increased ferritin
