Anaemia: 92 core conditions Flashcards
a bank of all of the 92 core conditions which can be examined, with descriptions, symptoms, treatments and differential diagnoses
what are the common or less common but dangerous causes of anaemia?
Fe deficiency
Pernicious anaemia
Folate deficiency
Normocytic anaemia
what are uncommon but illustrative causes of anaemia?
Haemoglobinopathies
Haemolytic anaemia
Marrow failure
what causes microcytic anaemia?
hypochromic microcytic= iron deficient
normochromic= thallassaemia
what is thallassaemia?
Inherited blood disorders that manifest as the production of reduced or zero quantities of hemoglobin.
manifests as either alpha or beta. alpha is only one alpha chain in the globin, beta is only one beta chain.
More common in Mediterranean ancestry
what causes normocytic anaemia?
normochromic= renal issues, anaemia of chronic disease
hyperchromic= autoimmune haemolytic anaemia, hereditary spherocytosis
what causes macrocytic anaemia?
hypochromic= low reticulocyte count
normochromic= liver disease, b12 deficiency
what are differentials for anaemia
crohns disease (b12 deficiency)
viral hepatitis
cancer (tiredness, SOB)
roles of b12 and folate in anaemia
act in nucleic acid production which is essential for DNA synthesis and thus production of RBC.
which groups are at risk of anaemia
children, pregnant women and elderly
what sizes of RBC are micro, normo and macrocytic?
micro= MCV <80
normo= MCV = 80-99
macro= mcv >100 fL
which cells are produced from haemapoetic stem cells?
common lymphoid progenitors and common myeloid progenitors
which cells are produced from the common lymphoid progenitors?
lymphoblasts which then produce:
B cells, T cells, Natural Killer cells
immature dendritic cells are also produced by CLP
which cells are produced by the common myeloid progenitor cells?
premonocytic cells, mast cell precursors
megakaryocytic, erythroblasts
myeloblasts
which cells do myeloblasts produce
Band Neutrophils
Band basophils and band eosinophils
these then produce their name sakes when in the blood stream
when does most of extramedullary blood cell production occur?
foetal haemopoesis
in the liver and spleen
in infection there is an increase of lymph node production of blood cells
what causes sickle cell anaemia
is a genetic condition caused by a non conservative missense.
Glutamine is replaced by valine in the beta globin chain.
this alters the interactions of the polymer as Glu is hydrophilic and valine is hydrophobic
what type of genetic inheritance is sickle cell anaemia?
autosomal recessive
what is sickle trait
when only one gene is affected
not symptomatic unless exposed to extreme conditions
what are the benefits of sickle trait
less susceptible to plasmodium falciparum malaria
what is HbS
haemoglobin with two beta chains affected by the mutation
what are characteristics of HbS
it can carry oxygen well
when deoxygenated its shape alters, allowing aggregation of other HbS
this forms long polymers, forming the sickle.
which conditions increase the risk of sickling
acidosis (decreases affinity for oxygen)
low flow vessels
what does repeated sickling cause?
weakened cell membrane
premature destruction (life span of 10-20 days vs 120)
this leads to anaemia and increased Hb
this causes a decrease of haptoglobin (the protein which clears out haemoglobin) as it is used up faster than it is created.
this is a clinical test!
