Anaemia: 92 core conditions

Question 1

what are the common or less common but dangerous causes of anaemia?

Answer 1

Fe deficiency
Pernicious anaemia
Folate deficiency
Normocytic anaemia

Question 2

what are uncommon but illustrative causes of anaemia?

Answer 2

Haemoglobinopathies
Haemolytic anaemia
Marrow failure

Question 3

what causes microcytic anaemia?

Answer 3

hypochromic microcytic= iron deficient
normochromic= thallassaemia

Question 4

what is thallassaemia?

Answer 4

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

Question 5

what causes normocytic anaemia?

Answer 5

normochromic= renal issues, anaemia of chronic disease
hyperchromic= autoimmune haemolytic anaemia, hereditary spherocytosis

Question 6

what causes microcytic anaemia?

Answer 6

hypochromic= low reticulocyte count
normochromic= liver disease, b12 deficiency

Question 7

what are differentials for anaemia

Answer 7

crohns disease (b12 deficiency)
viral hepatitis
cancer (tiredness, SOB)

Question 8

roles of b12 and folate in anaemia

Answer 8

act in nucleic acid production which is essential for DNA synthesis and thus production of RBC.

Question 9

which groups are at risk of anaemia

Answer 9

children, pregnant women and elderly

Question 10

what sizes of RBC are micro, normo and macrocytic?

Answer 10

micro= MCV <80
normo= MCV = 80-99
macro= mcv >100 fL

Question 11

which cells are produced from haemapoetic stem cells?

Answer 11

common lymphoid progenitors and common myeloid progenitors

Question 12

which cells are produced from the common lymphoid progenitors?

Answer 12

lymphoblasts which then produce:
B cells, T cells, Natural Killer cells
immature dendritic cells are also produced by CLP

Question 12

which cells are produced by the common myeloid progenitor cells?

Answer 12

premonocytic cells, mast cell precursors
megakaryocytic, erythroblasts
myeloblasts

Question 12

which cells do myeloblasts produce

Answer 12

Band Neutrophils
Band basophils and band eosinophils
these then produce their name sakes when in the blood stream

Question 13

when does most of extramedullary blood cell production occur?

Answer 13

foetal haemopoesis
in the liver and spleen

in infection there is an increase of lymph node production of blood cells

Question 13

what causes sickle cell anaemia

Answer 13

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

Question 13

what type of genetic inheritance is it?

Answer 13

autosomal recessive

Question 13

what is sickle trait

Answer 13

when only one gene is affected
not symptomatic unless exposed to extreme conditions

Question 13

what are the benefits of sickle trait

Answer 13

less susceptible to plasmodium falciparum malaria

Question 13

what is HbS

Answer 13

haemoglobin with two beta chains affected by the mutation

Question 13

what are characteristics of HbS

Answer 13

it can carry oxygen well
when deoxygenated its shape alters, allowing aggregation of other HbS
this forms long polymers, forming the sickle.

Question 14

which conditions increase the risk of sickling

Answer 14

acidosis (decreases affinity for oxygen)
low flow vessels

Question 15

what does repeated sickling cause?

Answer 15

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!