Anaemia

Question 1

what is the definition of anaemia?

Answer 1

when there is insufficiency in amount of red blood cells or haemoglobin

generally based on Hb levels in the blood

Question 2

what is normal Hb level for adult male?

Answer 2

<130

Question 3

what is normal Hb level for adult female who is not pregnant as well as children aged 6 years - 14 years?

Answer 3

<120

Question 4

what is normal Hb level for pregnant adult female and children aged 6 months - 6 years?

Answer 4

<110

Question 5

what is haematocrit?

Answer 5

measure of how much of the volume of blood if composed of red blood cells

expressed as a percentage or ratio of total blood volume

Question 6

what is normal haematocrit levels in males vs females?

Answer 6

males - 0.38-0.52

females - 0.37-0.47

Question 7

in general Hb and haematocrit are good measured of RBC mass but in what two circumstances are they not and why?

Answer 7

acute haemorrhage (no change in parameters even though considerable amount of RBC lost, this is due to loss being proportional to all other constituents of blood)

large volume fluid resuscitation (will expand the plasma, which will show reduction in Hb / haematocrit when there hasnt actually been one)

Question 8

the cause of anaemia can be divided into what two categories which can be differentiated by reticulocyte count?

Answer 8

decreased production (low reticulocyte count)

• hypoproliferative = reduced amount of erythropoiesis
• maturation abnormality = erythropoiesis present but ineffective (can be due to cytoplasmic defect ie impaired haemoglobinisation or nuclear defect ie impaired division)

increased loss / destruction = high reticulocyte count

• bleeding
• haemolysis

Question 9

what are the two different types of abnormal maturation anaemia indicated by low reticulocyte count?

Answer 9

macrocytic = high MCV (consider problem with maturation)

microcytic = low MCV (consider problem with haemoglobinisation)

Question 10

is hypoproliferative anaemia (reduced amount of erythropoiesis) microcytic or macrocytic?

Answer 10

neither - normocytic

Question 11

what is the general presentation of anaemia?

Answer 11

resp = exertional, SOB 
CVS = dizziness, palpitations, worsening of angina 
general = fatigue, headache, tinnitus, fainting, anorexia 

O/E = conjunctival or general pallor