Brainscape's Knowledge GenomeTM

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


See full index

BDS2 BAMS > Anaemia > Flashcards

Anaemia Flashcards

1
Q

anaemia

A

reduction in haemoglobin in the blood

below normal for population

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

3 causes of low Hb

A
  • reduction production
  • increased losses
  • increased demand
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

RBC life span

A

120 days

haemoglobin is recycled in that time

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

what are 2 processes of getting anaemia?

A
  • reduced normal red cells

- normal red cells but reduced Hb

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

how can reduced normal red cells lead to anaemia?

A

marrow failure

- low RBC count, less Hb present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

aplastic anaemia marrow appearance

A

not making cells
acellular
easy to spot problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the appearance of normal marrow?

A

cellular
bone trabecular
cells made by stem cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how can having a normal red cells count but reduced Hb lead to anaemia?

A

making enough RBC but not enough Hb too go into them

constituents of Hb not made in adequate numbers

  • haem production needs folic acid and vitamin B12
  • globin chain production arises from abnormal genetic code so wrong proteins

deficiency states - Fe, Folate, Vit B12

abnormal globin chains

  • Thalassaemia
  • Sickle Cell

chronic inflammatory disease

  • rheumatoid arthritis supresses ability to make Hb
  • not missing constituents just not forming Hb
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

haematinics are

A

things used to make red blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what 3 things are heamatinincs?

A
  • iron
  • vitamin B12
  • folic acid (folate)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

iron sources

A
  • meat
  • green leafy vegetables
  • iron tablets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what form must iron be in to be absorbed?

A

2+

haem-based iron can be easily absorbed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is a haem-based iron (2+) source?

A

meat based products

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

what is iron stored in cell as?

A

ferritin

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

how is iron transferred from cell to blood?

A

from storage protein ferritin into blood as haem again

many blood transporters e.g. trasnferrin

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

what is a stable measure of iron store?

A

ferritin

ferritin in blood is proportionally accurate to how much is stored in cells

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

what disease can reduce iron absorption?

A

achlorhydria

coeliac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is achlorhydria and have can that reduce iron absorption?

A

Lack of stomach acid
- no conversion of non-haem iron (3+ to 2+)

may be Drug induced (Proton Pump Inhibitors)
- get rid of stomach acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how can coeliac disease reduce iron absorption?

A
  • Lose villi on endothelial of small intestine

- Flattening of intestinal lining - less SA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how can someone have iron loss? (4)

A

anything that makes you bleed - internal and external

Gastric erosions and ulcers
- Acid, ulceration expose connective tissue

Inflammatory Bowel disease

  • Crohn’s disease
  • Ulecerative colitis

Bowel Cancer
- Colonic cancer
- Rectal Cancer
Small amount of bleeding over time

Haemorrhoids
- Notice as not passed through GI so still red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

vitamin B12 sources

A

animal products mainly

also marmite, green leafy veg

cannot be made by humans - need to obtain through diet as made only by bateria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how vitamin B12 absorbed?

A

Intrinsic factors combine with vitamin B12 to be absorb form GI
- need both

Receptors end of ileum that pick up intrinsic factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what can be given if vitamin B12 deficient?

A

injections

not taken via GI tract so can be absorbed readily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what does folic acid do?

A

combines with iron

needed for DNA synthesis for RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

if there is a deficiency in iron and vitamin B12 then there is…

A

problem in absorption

26
Q

if only iron or vitamin B12 then there is…

A

problem in diet

27
Q

vitamin B12 deficiency can be due to (3)

A

Lack of intake – strict vegans

Lack of intrinsic factor

  • Autoimmune stomach disease (Pernicious anaemia)
  • Gastric disease

Disease of terminal Ilium
- Crohn’s disease

28
Q

folic acid sources

A

green leafy vegetables

29
Q

folic acid deficiency can be due to (2)

A

Lack of intake
- Peculiar diet habits

Absorption failure

  • Jejunal disease – coeliac disease
  • Usually seen co-deficient with iron
30
Q

what can folic acid deficiency lead to?

A

Neural Tube defect in foetus
- Cannot be fixed – permanent defect

Fails to close properly
- Spinal column as fails to close
Nerves below not formed correctly – lower limb, bowels etc

31
Q

why is folic acid important?

A

Needed for nerve maturation - spina bifida deficiency in pregnancy

32
Q

how to test for haematinic deficiencies?

A

blood tests

  • ferritin (iron)
  • vitamin B12
  • folate

can be haematinic deficient before anaemic as Hb as 120 day life span

33
Q

what is thalassaemia?

A

normal haem production but genetic mutation of globin chains

  • alpha chains (alpha thalassaemia)
  • beta chains (beta thalassaemia)
    run in populations
34
Q

what are the possible clinical effects of thalaessmia?

A

Mild – no effects
- Their normal is having a low Hb – new homeostasis

Chronic anaemia

Marrow hyperplasia (skeletal deformities)

  • Bone marrow having to make more globin
  • Need more as only some used, change in structure

Splenomegaly

  • Spleen removes from blood e.g. wrong RBC due to wrong globin structure
  • Spleen gets bigger as higher workload

Cirrhosis

  • Too much iron in blood, as over making haem as lack of correct globin
  • Haem is no use in excess – storage issue

Gallstones
- Due to more haem for recycling

35
Q

management of thalassaemia

A

Best left if not a big issue to patient

Blood transfusions
- Need to give more haemoglobin as not making enough themselves

but Prevent iron overload
- Issue as normal haem so giving excess so too much iron –> cirrhosis and gallstone

36
Q

what is sickle cell anaemia?

A

abnormal globin chains, so change in way globin behaves when O2 levels are reduced in RBC

37
Q

what occurs to RBC in low O2 in sickle cell anaemics?

A

change in shape
- from flat disc to bent disc shape

cannot fit through capillaries

  • blockage
  • no blood flow
  • serious –> hypoxia and tissue ischaemia
38
Q

what does someone have if they are heterozygous sickle cell anaemic?

A

sickle cell trait but not disease

39
Q

what does someone have if they are homozygous sickle cell anaemic?

A

sickle cell disease

40
Q

how can RCC and HCT losses occur for normal red blood cells?

A

bleeding

usually GI bleeding
- no source of outside bleeding

unexplained anaemia (scope down to find source)

41
Q

how can RCC and HCT losses occur for abnormal red blood cells?

A

autoimmune

hereditary - SICKLE, G6PD, spherocytosis

  • Cells have reduced life span (<120 days) [Abnormal in RBC shape and duration; May need to make RBC faster to keep level]
  • can lead to lower RBC as life span been reduced as removed by the spleen
42
Q

cases when there is an increase demand of RBC so higher chance if becoming anaemic

A
  • after pregnancy (if blood doesn’t physiologically adapt during to increase volume with fewer but proportional RBC)
  • malignant disease (tumours)
43
Q

3 types of RBC mean cell volumes (MCV)

A

microcytic

macrocytic

normocytic

44
Q

microcytic

A

small RBC
- Fe def , lack of ability to make haem (anaemia and Thalassaemia)

shrunk too far as reduced cellular content

45
Q

macrocytic

A

large RBC
- B12/folate def., Retics

RBC start big and decrease in size with maturation between RBC precursor and when they should enter circulation
- not shrunk enough so larger than normal expected size

46
Q

normocytic

A

normal RBC

- shrunk to normal expected size

47
Q

what are reticulocytes?

A

almost mature RBC (appear bigger as still immature RBC)

48
Q

why do we have reticulocytes in circulation sometimes?

A

Released early into the circulation to replace losses

  • E.g. after donation, sudden recent blood loss
  • Replace loss quickly

Fluid replaced easily
- Bone marrow released immature RBC to try and replace cellular content

49
Q

what will reticulocytes do to MCV?

A

increase MCV

- still have cellular parts to them

50
Q

3 stages to run through in anaemia diagnosis

A

what is the Hb?

  • Normal or not normal
  • determine degree of anaemia

what are the RCC and HCT?
- cell deficiency (right number RBC or reduced) or Hb formation deficiency

What is the MCV?
- Is there a deficiency picture? 
- What is the likely deficiency? 
(Small cells – iron deficiency, Thalassemia
Big cells – B12, folic acid deficiency)
51
Q

3 stereotypical signs of haematinic deficiencies (do not base diagnosis off)

A

Pale mucosa – more likely if anaemic.

Smooth tongue – iron deficiency

‘beefy’ tongue – vitamin B12 deficiency

52
Q

anaemia signs

A

Pale

Tachycardia
- Faster HR as pumping RBC more as same volume of oxygen is carried by fewer RBC

Rarely: enlarged liver and spleen

53
Q

anaemia symptoms

A
  • Tired & weak
  • Dizzy
  • Short of breath
  • Palpitations (Awareness of increase in HR)
54
Q

6 investigations for anaemia

A

HISTORY

FBC (Ferritin & RC Folate/vit B12 )
- All cells and Haematinics

FOB (Faecal Occult Blood)

  • Easy – looks for changed haemoglobin
  • Small sample of stool mixed with chemical agent to ID altered haemoglobin
  • See if any blood in stool – similar for bowel cancer

Endoscopy/Colonoscoopy

Renal Function

  • Kidneys make erythropoirtin – needed for RBC production
  • normocytic anaemia – correct structure but deficient as not making at all

Bone Marrow examination

55
Q

what can GI bleeding in young be due to?

A
  • drink
  • menstruation
  • worry
56
Q

what can GI bleeding in older people be due to?

A

bowel disease and cancer

polyp can become malignant

57
Q

3 methods for anaemia treatment

A

treat the cause

Replace haematinics

  • FeSO4 200mg tds for 3months
  • 1mg IM vitamin B12 x 6 then 1mg/2 months
  • 5mg Folic acid daily

Transfusions - production failure

  • If cannot make haemoglobin correctly (Bone marrow failure)
  • Thalassemia

Erythropoietin - production failure

  • If suffer from Renal disease
  • Erythropoietin injections can boost haemoglobin levels to normal
58
Q

dental aspects of anaemia

A

need to correct anaemia before commencing any treatment

General Anaesthesia – O2 capacity

  • Send to hospital not in surgery
  • Need to go through risk as and benefits - Risk of hypoxia higher

Deficiency States - Fe usually

  • mucosal atrophy
  • Candidiasis
  • ROU – recurrent oral ulceration
  • Dysaesthesia

Check Haematinics in mucosal diseases

Sickle cell disease

  • check all patients of negroid background before GA
  • sickledex test even if no anaemia
59
Q

general anaesthesia risk for anaemics

A

greater risk of hypoxia

60
Q

iron deficiency oral manifestations

A
  • mucosal atrophy
  • Candidiasis
  • ROU – recurrent oral ulceration
  • Dysaesthesia

BDS2 BAMS (54 decks)

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