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INTERNAL MED 3+ conditions > Anaemia > Flashcards

Anaemia Flashcards

1
Q

Define anaemia (words and lab results)

A
  • Lack of red blood cells and/or haemoglobin
  • this reduced the ability of blood to transfer oxygen to the tissues

Men <130g/L
Women <120g/L

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2
Q

Defining anaemia into 3 categories and subcategories

A
  • Microcytic = hypo/normo/hyperchromic
  • Normocytic = hypo/hyperproliferative
  • Macrocytic = megaloblastic/nonmegaloblastic
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3
Q

Define microcytic anaemia

A

MCV <80fL

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4
Q

Define normocytic anaemia

A

MCV 80-100fL

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5
Q

Define macrocytic anaemia

A

MCV >100fL

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6
Q

Causes of hypochromic microcytic anaemia

A
  • Iron deficiency
  • Thalassemia
  • Siderblastic
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7
Q

Cause of normocytic microcytic anaemia

A

Anaemia of chronic disease/inflammation

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8
Q

Cause of hypochromic microcytic anaemia

A

Congenital spherocytic/hereditary sperocytosis

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9
Q

Causes of megaloblastic macrocytic anaemia

A
  • Vitamin B12 deficiency
  • Folic acid deficiency
  • Some medications - chemo, antiseizure, antiretrovirals
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10
Q

Define megalobastic anaemia

A
  • Errors in RBC DNA production
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11
Q

Causes of non-megaloblastic macrocytic anaemia

A
  • Alcoholism
  • Liver disease
  • Hypothyroidism
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12
Q

Haemolytic anaemia - subtype of anaemia

A

Normo/micro/macro

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13
Q

Signs and symptoms - 2 groups

A
  • Decreased O2 delivery

- Hypovolaemia

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14
Q

Signs and symptoms of anaemia

A
  • Exertional and rest dyspnoea
  • Fatigue
  • Bounding pulse
  • Palpitations
  • Lethargy
  • Confusion
  • Congestion failure
  • Angina
  • Arrhythmia
  • MI
  • Lassitude (lack energy)
  • Muscle cramps
  • Postural dizziness
  • Syncope
  • Hypotension
  • Shock - death
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15
Q

Features on an exam - anaemia

A
  • Pallor
  • Jaundice
  • Lymphadenopathy
  • Hepatosplenomegaly
  • Bone tenderness
  • Petechiae
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16
Q

Anaemia risk factors

A
  • Diet lacking vitamins/iron
  • Intestinal disorders
  • Menstruation
  • Pregnancy
  • Chronic conditions = cancer, kidney
  • Family history
  • Certain infections
  • Autoimmune disorders
  • Alcoholism
  • Age >65
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17
Q

Broad categories - aetiology of anaemia

A
  • Blood loss
  • Nutrient deficiency and depletion
  • Acquired bone marrow disease
  • Toxin exposure
  • Chronic systemic disease
  • Immune reactions
  • Infections
  • Genetic disorders
  • Microvascular disease
  • Other
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18
Q

Nutrient deficiencies causing anaemia

A
  • Iron deficiency
  • Vitamin B12 deficiency
  • Folate deficiency
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19
Q

What is haemoglobinuria?

A
  • Iron loss in urine (rare)
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20
Q

What are the consequences of vitamin B12 deficiency

A
  • Megaloblastic macrocytic anaemia

- Neurological disorders

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21
Q

What are vitamin B12 and folate important for?

A
  • Co-factors in the synthesis of DNA
22
Q

What is pernicious anaemia?

A
  • Lack intrinsic factor = impaired uptake of vitamin B12
23
Q

Who/when do folate requirements increase?

A
  • Infants
  • Pregnancy
  • Lactation
  • Malignancy
24
Q

Relationship between alcohol and folate

A

Alcohol = excess biliary folate excretion

25
Q

Acquired bone marrow diseases causing anaemia

A
  • Myeloblastic syndromes
  • Leukaemias
  • Infiltration of bone marrow by secondary malignancy
  • Aplastic anaemia
  • Pure RBC aplasia
26
Q

What is myeloblastic syndrome

A
  • Uncontrolled proliferation of neoplastic multipotential haem cells - compromises normal cells
27
Q

Causes of myeloblastic syndromes

A
  • Chromosomal abnormality
  • Chemotherapy
  • Radiotherapy
28
Q

Type of anaemia caused by myeloblastic syndrome

A
  • non-megaloblastic macrocytic anaemia
29
Q

Describe aplastic anaemia

A
  • Stem cell failure
  • Pancytopaenia with no splenomegaly
  • Inherited or acquired
  • Typically present with recurrent infection
  • Toxic causes
  • Diagnosis - BM aspiration and biopsy
30
Q

What does bone marrow look like in aplastic anaemia

A

Hypocellular

31
Q

Describe pure RBC aplasia

A
  • Congenital or acquired impairment of erythroid progenitor cells
  • Infections and medications cause a self-limiting illness
  • Autoimmune = chronic condition
32
Q

Drugs and anaemia

A
  • Can cause a direct or immune mediated RBC haemolysis

- Can interfere with DNA synthesis

33
Q

Radiation exposure causes what type of blood condition

A

Pancytopaenia

34
Q

Lead toxicity and anaemia

A
  • Lead competes with zinc = zonc needed as co-factor in haem synthesis
35
Q

How dos alcohol cause anaemia

A

Suppress bone marrow

36
Q

What kind of anaemia is caused by chronic disease

A

Can range from mild hypoproliferative normocytic to microcytic (co-exist with Fe def)

37
Q

Type of anaemia with chronic kidney disease

A

Normocytic or microcytic

38
Q

Type of anaemia with chronic liver disease

A

Non-megaloblastic macrocytic

39
Q

Type of anaemia caused by hypothyroidism

A

Hypoproliferative normocytic (due to the loss of stimulatory effect of thyroid hormones of erythropoiesis)

40
Q

2 types of immune reactions causing anaemia

A
  • Autoimmune haemolytic anaemia (autoantibodies)

- Alloimmune haemolytic anaemia (ABO incompatibility)

41
Q

Infections that can cause anaemia

A
  • CMV
  • Infectious mononucleosis
  • Malaria
  • Parvovirus B19
  • Mumps
42
Q

Genetic disorders that can cause anaemia

A
  • Thalassemias (alpha and beta) - AR
  • Sickle cell (beta chain defect) - AR
  • Hereditary spherocytosis - AD
  • G6PD - X linked
  • Fanconi (congenital bone marrow failure - AR/X-linked
43
Q

Microvascular diseases causing anaemia

A
  • Haemolytic uraemic syndrome
  • Disseminated intravascular coagulation
  • Thrombotic thrombocytopenic purpure
  • Haemangiomas
  • Malignant hypertension
  • Prosthetic valves and surfaces
44
Q

Haemolytic uraemic syndrome

A
  • Damage to endothelium of glomerular - causes fragmentation and shearing of RBC
  • Also causes thrombocytopenia and nephropathy
45
Q

Haemangioma

A
  • Vascular tumours - abnormal angiogenesis and over-proliferation of blood vessels
46
Q

Other causes of anaemia (don’t fall into other categories)

A
  • Pregnancy (dilution effect)
  • Thermal burns
  • Hospital acquired anaemia (increased phlebotomy and iatrogenic blood loss)
47
Q

Anaemia epidemiology

A
  • Globally affects 24.8% of people

- Most common cause - iron deficiency - most common in premenopausal women

48
Q

Describe hypoproliferation normocytic anaemia

A
  • Reticulocyte count of <2%

- Leukaemia, aplastic, bone marrow failure

49
Q

Describe hyperprolferative normocytic anaemia

A
  • Reticulocyte count of >2%

- Haemorrhage and haemolysis

50
Q

Treatments for anaemia

A

DEPENDS ON CAUSE

  • Vitamin/iron sup
  • Iron injections
  • Vitamin B12 injections
  • Antibiotics (if infectious cause)
  • Blood transfusion
  • Oxygen therapy
  • Surgery (abnormal bleeding)
  • Splenectomy (severe haemolytic anaemia)

INTERNAL MED 3+ conditions (18 decks)

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