Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Yr5 Haematology > Anaemia > Flashcards

Anaemia Flashcards

1
Q

What are the causes of iron deficiency anaemia?

A

Blood loss: Menorrhagia, GI, NSAID, Colonic/gastric Ca
Poor diet: Kids
Malabsorption: Coeliac, IBD, PPI, H.Pylori, ↓Vit C
Excess iron requirement: Pregnancy, kids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where is iron absorbed?

A

Duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the causes of microcytic anaemia?

A 
Iron deficiency
Lead poisoning
Chronic disease
Sideroblastic
Thalassaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the causes of normocytic anaemia?

A 
Haemolytic anaemia
BM disorder
Hypersplenism
Acute blood loss
Chronic disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the causes of macrocytic anaemia?

A 
Vit B12 & folate deficiency
Liver disease (OH-)
Hypothyroidism
Reticulocytosis
Myelodysplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the early & late Sx of iron deficiency anaemia?

A 
EARLY:
Dyspnoea on exertion
Fatigue
LATE:
Koilonychia
Atrophic glossitis
Angular cheilosis
Pale conjunctiva
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are worrying signs in iron deficiency anaemia?

A 
Acute dyspnoea
Dizzy/syncope
Palpitations
Chest pain 
↑HR, ↓BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is iron deficiency anaemia investigated?

A

Bloods: ↓MCH ↓MCV ↓Hb ↑TIBC
↓Ferritin = DIAGNOSTIC
Blood Film: Microcytic, hypo chromic, target cells, poikilocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In iron deficiency anaemia what investigations can be done to look for specific causes?

A 
Coeliac Screen: TTG, endoscopy & biopsy
Urine Dip: Bladder Ca
Endoscopy: Upper/Lower GI
H.Pylori Test: Urea breath test
DRE: Malaena/fresh blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is iron deficiency anaemia managed?

A

Iron rich foods
Ferrous Sulphate: 200mg TDS, start before results of Ix, expect ↑ >10g/L/week, continue for 3m after Fe levels are normal, check FBC 2-4w post Tx then 2-4m
Blood transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When in iron deficiency anaemia should a blood transfusion be considered?

A

Hb <80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where is folate & B12 absorbed?

A 
Folate = Jejunum
B12 = Ileum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does B12 require to be absorbed?

A

Intrinsic factor

Produced by gastric parietal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 2 types of macrocytic anaemia? What are the causes?

A

Megaloblastic: B12 (CD, Addison’s), Folate (Hep, leukaemia, diet), Cytotoxic (Azathiprine)
Non-megaloblastic: OH- liver disease, hypoThy, Pregnancy, Myelodysplasia, reticulocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How are megaloblastic cells produced?

A

Abnormal erythroblasts in BM
Delayed maturation of nucleus relative to cytoplasm
Defective DNA synthesis
LARGE cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How are non-megaloblastic cells produced?

A

Issues relating to outside of the BM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the initial sign of macrocytic anaemia

A

Dyspnoea on exertion

Fatigue

18
Q

What are the late signs of macrocytic anaemia?

A 
Angular stomatitis
Glossitis
Pale conjunctiva
Lemon tinge
Peripheral neuropathy
19
Q

How is macrocytic anaemia investigated?

A

Bloods: ↓Hb, ↑MCV, ↑Ferritin, TIBC n
Blood Film: Hypersegmented polymorphs = B12/FOLATE, Target cells = LIVER DISEASE
PERNICIOUS anaemia: Parietal cell Abx, IF auto-Abx
↓B12,↓Folate
BM Biopsy: If no obvious cause- EXCLUDE leukaemia

20
Q

What should be done before prescribing folic acid? Why?

A

CHECK B12 LEVELS
Folic acid can exacerbate subacute combined degeneration of the spinal cord
If BOTH B12 & Folate deficient- start B12 FIRST then once B12 normalises start Folic acid

21
Q

How is a folate deficiency treated?

A

Diet: Green veg, nuts, liver

Folic acid: 5mg OD for 4m, look for Hb ↑10g/L/week

22
Q

How is B12 deficiency treated?

A

B12 injections: Hydroxocobalamin
Initially - 1mg IM alt days for 2w
Maintenance- 1mg IM/3m for life

23
Q

How is B12 absorbed?

A

B12 binds to IF in stomach → absorbed in terminal ileum
B12 def = ↓Thymidine synthesis → ↓DNA synthesis rate
↓RBC production

24
Q

What is a major complication of untreated B12 deficiency?

A

Subacute combined degeneration of the spinal cord
Insidious onset
Symmetrical loss of dorsal column & corticospinal tracts

25
Q

What does the dorsal column & corticospinal tracts control?

A

DC: Sensory & LMN signs
CT: Motor & UMN signs

26
Q

What are the classic signs of Subacute combined degeneration of the spinal cord?

A

Extensor plantar
Absent ankle jerk
Absent knee jerk

Proprioception & vibration 1st to be lost
Ataxia leads to stiffness & weakness

27
Q

How does haemolytic anaemia occur?

A

Premature breakdown of RBCs before their natural lifespan
May be
Intravascular (= jaundice)
Extravascular (immune complex formation or RBC defect→ spleen)

28
Q

What are the different types of haemolytic anaemia?

A 
Acquired (Immune mediated)
Acquired (non-immune mediated)
Hereditary (enzyme defect)
Hereditary (membrane defect)
Haemoglobinopathy
29
Q

How are immune and non-immune acquired haemolytic anaemia differentiated between?

A 
Immune = +ve Coombs test
Non-immune = -ve Coombs test
30
Q

What are the causes of acquired immune mediated haemolytic anaemia?

A

Drug induced: Penicillin, Quinine
Autoimmune: Warm (IgG require steroids/immunoS) or Cold (IgM, worse in cold)
Paroxysmal cold haemoglobinuria (syphilis/viral infection predisposes to cold)
Coombs -ve AIHA (Hepatitis B, C, AI), Post flu vaccine

31
Q

What are the causes of non-immune acquired haemolytic anaemia?

A

Malaria: RBC haemolysis & haemoglobinuria

Microangiopathic haemolytic anaemia (MAHA): Mechanical disruption of RBC (HUS, DIC, Pre-eclampsia)

32
Q

What are the causes of hereditary (enzyme defects) haemolytic anaemia?

A

G6PD: Most common, X-linked, precipitated - Aspirin/Cipro/Sulphonamides
Pyruvate kinase def: Autosomal recessive, ↓ATP limits RBC survival

33
Q

What are the causes of hereditary (membrane defects) haemolytic anaemia?

A

Spherocytosis: Spherical RBCs trapped in spleen = Splenomegaly & Extravascular haemolysis
Elliptocytosis: Folate & splenectomy

34
Q

What are the causes of haemoglobinopathy?

A

Sickle cell

Thalassaemia

35
Q

What are the Sx of haemolytic anaemia?

A

Jaundice
Dark urine (Haemoglobinuria → intravascular cause)
Fatigue & palpitations
Splenomegaly (Extravascular- CLL, SLE, Malaria)
Fever (?malaria)

36
Q

What Sx might point to a hereditary cause?

A

Fhx of jaundice or anaemia

37
Q

How is haemolytic anaemia investigated?

A

Bloods: FBC (Reticulocytes), LDH, LFTs (Bili),
Blood Film
Urine: Haemoglobin & urobilinogen
Coombs test: Direct = Autoimmune, Indirect = ante-natal screening
Imaging: USS- spleen, CXR

38
Q

What might the different blood films show in the different haemolytic anaemias?

A 
Thalassaemia = ↓MCH ↓MCV 
Sickle Cell Anaemia = Sickle shaped cells
MAHA = Schistocytes
G6PD = Heinz bodies/Bite cells
HS or AI = Spherocytes
Malaria = Thick &amp; thin film
39
Q

How is ↑RBC breakdown investigated?

A

Anaemia w/n or ↑MCV
↑Unconjugated Bilirubin (pre-hepatic)
↑Urinary urobilinogen
↑ Serum LDH

40
Q

How is ↑RBC production investigated?

A

↑MCV

↑Reticulocytes

41
Q

How is extra/intravascular causes of haemolytic anaemia characterised?

A

EXTRA: Splenomegaly
INTRA: Haemoglobinuria, ↑Free plasma Hb, ↓Plasma Haptoglobin , haemosiderinaemia

Yr5 Haematology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions