Anaemia Flashcards
give two causes of microcytic anaemia
iron deficiency anaemia
haemoglobinopathy/thalassaemia
how do you manage IDA
ferrous sulphate 200mg tds until FBC is normal + 3/12
what happens in thalassaemia
people produce too little haemglobin
- not enough globin chains
give two causes of a normoctyic anaemia
anaemia of chronic disease
bone marrow failure
give some examples of chronic diseases that may cause anaemia of chronic disease
chron's arthritis osteomyelitis TB Cancer
describe iron studies seen in anaemia of chronic disease
normal/high ferritin
low serum iron
low transferrin
describe roughly how anaemia of chronic disease occurs
iron becomes stuck in stores new red cells are hard to move low transferrin MCV starts to fall over time transferrin starts to fall resulting in failure to mobilise iron
what do you need to diagnsoe anaemia of chronic disease
- chronic disease
- inflammatory markers
- low transferrin
how do you manage anaemia of chronic disease
treat the cause!
do not prescribe iron or transfuse
describe pancytopenia
failure of red blood cells
- anaemia
- thrombocytopenia
- leukopenia
what blood abnormalities might you see in bone marrow failure
pancytopenia
what type of anaemia do you see in anaemia of chronic disease
normocytic anaemia
what type of anaemia do you see in IDA
microcytic anaemia
what type of anaemia do you see in bone marrow failure
normocytic anaemia
what type of anaemia do you see in thalassaemia
microcytic anaemia
what can cause bone marrow failure
malignancy
drugs (chemo, other cytotoxics, antibiotics)
give some causes of macrocytic anaemia
haematinic deficiency (B12/folate)
Haemolysis
(other: altered lipid content, liver disease, alcohol, drugs, hypothyroidism)
what type of anaemia would you see in haemolysis
macrocytic
what type of anaemia would you see in haematinic deficiency
macrocytic
describe the process of B12 deficiency
when B12 enters the stomach it comes into contact with a protein called INTRINSIC FACTOR, from GASTRIC PARIETAL CELLS.
the INTRINSIC FACTOR allows it to be absorbed in the small bowel, particularly in the small bowel
give some causes of B12 deficiency
vegans
pernicious anaemia
ileal disease
what causes pernicious anaemia
lack of intrinsic factor from gastric parietal cells
50% have autoimmune antibodies to IF
what roughly is haemolysis
shortened red cell survival
what should you always check before replacing folate
that B12 is normal
how do you manage B12 deficiency
give x6 loading injections over 2 weeks, then once every 3 months
give some signs of haemolysis
jaundice
dark urine
signs of anaemia
splenomegaly
give some intrinsic causes of haemolytic anaemia
sickle cell disease
thalassaemia
G6PD deficiency
give some extrinsic causes of haemolytic anaemia
EBV] typhoid E.coli leukaemia lymphoma tumours HELLP hepatitis SLE
what tests should you do if you suspect haemolytic anaemia
blood film
coomb’s test
get a haematologist!
