Anaemia Flashcards

1
Q

how can anaemia be broadly classified? (think very broad)

A

RBC size

mechanism

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2
Q

what are the ways of classifying anaemia based on rec cell size and give their reference values

A

macrocytic (MCV>100)
normocytic (MCV80-100)
microcytic (MCV<80)

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3
Q

what is meant by megaloblastic anaemia?

A

a type of macrocytic anaemia

occurs due to impaired DNA synthesis in RBC production

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4
Q

give causes of macrocytic anaemia

A
B12 deficiency
folate deficiency
alcoholism
liver disease
drug side effects (azathioprine, methotrexate)
hypothyroidism
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5
Q

give examples of megaloblastic anaemia

A

B12 deficiency

folate deficiency

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6
Q

give causes of normocytic anaemia

A

anaemia of chronic disease

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7
Q

give causes of microcytic anaemia

A

iron deficiency
thalassaemia
sideroblastic anaemia

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8
Q

what is meant by a dimorphic appearance?

A

when there are two populations of red cells on a blood smear

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9
Q

what can give a dimorphic appearance on a blood film?

A

blood transfusion e.g. for iron deificienct anaemia

sideroblastic anaemia

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10
Q

what does ferritin reflect?

A

iron stores

also acute phase reactant

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11
Q

what is the cut off required for transfusion?

A

Hb<7

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12
Q

how is iron absorbed?

A

in bowel and urinary tract via iron channels

some iron is stored in cells bound to ferritin

some is exported from the cell by ferroportin and binds to transferrin in the blood

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13
Q

how is iron excreted?

A

via shedding of the mucosal cells

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14
Q

where are ferroportin channels present?

A

bowel mucosa

macrophages

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15
Q

what happens to ferroportin channels in anaemia of chronic disease?

A

gets blocked by hepcidin to try and shut down iron supply to bacteria

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16
Q

what is hepcidin and what is its function?

A

peptide hormone produced by the liver
regulates iron homeostasis by blocking ferroportin in the gut thereby reducing ion absorption
also inhibits transport of iron out of macrophages

17
Q

how much iron is in one bag of blood?

A

250mg

18
Q

how would you treat iron deficiency anaemia?

A

ferrous sulphate

need to replenish Hb first, then replenish stores

19
Q

what are the ADRs of ferrous sulphate?

A

constipation
nausea
dark stools

20
Q

what is cosmofer and how is it given?

A

iron dextran

IV infusion day case, one off dose

21
Q

what are the indications for cosmofer?

A

can’t tolerate ferrous sulphate

malabsorption e.g. coeliac, colectomy