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Haematology & Oncology > Anaemia > Flashcards

Anaemia Flashcards

1
Q

Define Anaemia. Give Reference ranges.

A

Haemoglobin concentration below normal range.

  • males <125
  • females <115
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2
Q

What are symptoms of Anaemia?

A
  • Fatigue
  • reduced exercise tolerance
  • SOB: on exertion + at rest
  • Angina
  • HF
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3
Q

What are signs of anaemia?

A
  • Palor
  • Tachycardia
  • Heart Murmurs
  • Koilonychia (spoon finger nails (Fe deficiency)
  • Angular stomatitis
  • Glossitis (B12/Folate)
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4
Q

Define + give 3 examples of microcytic anaemia.

A

Low MCV (less than 82)

  • Iron deficiency (Micro + Iron both have I in)
  • Thalassaemia
  • RARE - chronic disease (give iron or EPO and achieve optimum disease management)
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5
Q

Define Macrocytic anaemia + give 2 examples.

A

high MCV.

megaloblastic causes:
Vit B12 deficiency
Folate deficiency

Non-megaloblastic causes:
alcohol
hypothyroidism

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6
Q

Give 4 examples of normocytic anaemia ya need to know.

A
  • Acute bleeding
  • Haemolysis congenitally acquired
  • Aplastic anaemia
  • Anaemia of chronic disease
  • pregnancy
  • bone marrow failure
  • hypothyroidism
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7
Q

How does the body adapt to being anaemic?

A
  • increased heart rate
  • Cardiomegaly
  • Increased cardiac output
  • Right shift oxygen dissociation
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8
Q

What are the 3 main causes of iron deficiency anaemia?

A
  • Reduced intake (unlikely in the UK)
  • Increased requirement - pregnancy, malabsorption, coeliac disease
  • Chronic blood loss - menorrhagia, Upper or Lower GI
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9
Q

How does one diagnose Fe deficiency anaemia?

A
  • Bloods (see other Flashie)
  • Hx
  • Examination
  • Ferritin
  • Gastroscopy + colonoscopy
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10
Q

what bloods do you do to investigate Fe deficiency anaemia?

A
  • FBC- Hb, MCV, MCHC
  • Serum Ferritin
  • Fe + TIBC (total Iron binding capacity)
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11
Q

When microcytic anaemia doesn’t respond to iron what is the likely cause? How does it happen?

A
  • sideroblastic anaemia an incomplete formation of red blood cells
  • can be congenital or acquired
  • hypochromic microcytic on film
  • sideroblasts in bone marrow + increased Fe+ stores
  • treat with Pyridoxine (vitamin B6)
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12
Q

How do you treat folate deficiency?

A
  • 5mg colic acid/day
  • 400mcg pregnancy prophylaxis
  • 5mg/day in pregnancy if at risk
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13
Q

What causesB12 deficiency?

What are it’s symptoms?

A
  • poor dietay intake (vegan/veggie because found in milk/meat)
  • malabsorption - pernicious anaemia, coeliac, tape worms

Sx - neuropsychiatric from irritability to psychosis
-neurological - parasthesia, neuropathy spinal cord degeneration

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14
Q

Tell me about pernicious anaemia?

A
  • autoimmune atrophic gastritis
  • more common in females
  • leads to a lack of intrinsic factor secretion and therefore B12/folate deficiency
  • associated with other AI disease
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15
Q

Specific investigations for pernicious anaemia?

A
  • IF antibodies

- parietal cell antibodies

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16
Q

Treatment for pernicious anaemia?

A
  • IM hydroxycobalamin (B12)
  • 1mg every other day til neuro signs stop
  • 1mg every 3/12 for life
17
Q

What drugs can cause aplastic anaemia?

A
  • phenytonin
  • cytotoxics
  • chloramphenicol
  • suphonamides

IF THEYRE BEEN PRESCRIBED IT ONCE AND CAUSED APLASTIC ANAEMIA DONT DO IT AGAIN

18
Q

3 broad sweeps of haemolytic anaemia?

A
  • membrane -spherocytosis
  • metabolic -GDP6 deficiency
  • haemoglobinopathies - thalassaemia + sickle cell
  • ACQUIRED (there’s bare)
19
Q

Acquired causes of haemolytic anaemia?

A

-immune:
-autoimmune
-allo-immune - transfusion reaction + newborn haemolytic ting
drugs - methlydopa, penicillin

  • Non-immune
    • TTP/HUS, DIC, malignancy, pre-elampsia
    • prosthetic heart valves
    • malaria
20
Q

Tell me about G6PD deficiency

A
  • most common in people from the med and africa
  • X-linked recessive (only affects males)
  • drugs and fava beans precipitate crisis
  • HEINZ bodies on film
  • G6PD enzyme assay to diagnose
21
Q

Tell me about thalassaemia.

A

-under/no production of one of the globin chains
-alpha = Cr 16, Beta = Cr 11 (chain affected)
-FBC, blood film, Hb electrophoresis to Ix
-regular blood transfuions hb >90
&therefore iron chelation w/ deferiprone (feri off de prone iron)
-stages = major, intermedia, carrier (need transfusion, jsut anaemia, fine)

22
Q

Tell me about sickle cell.

A
  • autosomal recessive affected beta-globulin production
  • common in africa
  • carrier = protection from falciparum malaria
  • Tx w/ hydoxycarbamide (stimulates feotal Hb = reduces sickling)
  • abx + imms for prophylaxis for splenic infarct

Haematology & Oncology (10 decks)

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