Anaemia

Question 1

What is Anaemia?

Answer 1

Anaemia is defined as a haemoglobin level <120g/L in female and <140g/L in male or <125g/L in adults
Always use your own lab’s test range

Question 2

What is the most common cause of anaemia?

Answer 2

Iron deficiency which is classed as microcytic anaemia based on MCV

Question 3

What is the simple pathophysiology of anaemia?

Answer 3

Anaemia develops when the rate of RBC production decreases and/or the rate of RBC loss increases. Anaemia is hence the presenting sign of a more serious underlying condition.

Question 4

What is used to classify Anaemia?

Answer 4

MCV-MCV is a measurement of the average size of your red blood cells. MCH results tend to mirror MCV results. This is because bigger red blood cells generally contain more hemoglobin while smaller red blood cells tend to have less.

Question 5

How many types of anaemia (based on MCV) are there?

Answer 5

3. Hypochromic microcytic anaemia (<80fL)
   Normochromic normocytic anaemia (80-96 fL)
   Marcocytic anaemia (>96fL)

Question 6

When should anaemia be considered in patients?

Answer 6

It should be considered in patients presenting with:
Fatigue
Low energy level
Pallor
Dyspnoea on exertion
As well in children with growth impairment

Question 7

Differentials of anaemia

Answer 7

Trauma 
Acute GI bleeding 
Surgery 
Menorrhagia 
Iron deficiency 
Vitamin B12 deficiency 
Folate deficiency 
Myelodysplastic syndrome 
Acute lymphocytic leukaemia 
Acquired aplastic anaemia 
Drug toxicity
Anaemia of chronic disease 
Chronic kidney disease
Chronic liver disease
Pregnancy

Question 8

Approach to investigating anaemia

Answer 8

The approach to any anaemia has four steps:

1. Establish the type of anaemia
2. Find the immediate cause of the anaemia
3. Treat the anaemia
4. Investigate and treat the underlying disease process that has caused the anaemia