Anaemia Flashcards

1
Q

What is the definition of anaemia?

A

A reduced total red cell mass

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2
Q

What will happen to the reticulocyte count in anaemias caused by a decreased production of red blood cells?

A

Low reticulocyte count

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3
Q

What will happen to the reticulocyte count in anaemias caused by an increased loss or destruction of red blood cells?

A

High reticulocyte count

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4
Q

What are the two main examples of anaemia caused by increased loss or destruction of red blood cells?

A

Bleeding and haemolysis

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5
Q

A blood film which is ‘polychromatic’ suggests the presence of what cells?

A

Reticulocytes

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6
Q

What products of red blood cell breakdown may be present in excess in patients with haemolytic anaemia?

A

Serum unconjugated bilirubin and urinary urobilinogen

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7
Q

What type of murmur may be heard in patients with anaemia?

A

Ejection systolic murmur loudest over the apex

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8
Q

What cause of a microcytic, hypochromic anaemia is caused by a deficiency of globin chains, rather than a deficiency of haem?

A

Thalassaemia

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9
Q

What type of anaemia (i.e. micro, normo or macrocytic) is sideroblastic anaemia?

A

Microcytic anaemia

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10
Q

What is the most common cause of microcytic anaemia?

A

Iron deficiency

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11
Q

What happens to the ferritin level in microcytic anaemia caused by iron deficiency?

A

Low ferritin

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12
Q

What happens to the ferritin level in microcytic anaemia not caused by iron deficiency?

A

High/normal ferritin

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13
Q

What happens to the total iron binding capacity in microcytic anaemia caused by iron deficiency?

A

High total iron binding capacity

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14
Q

What happens to the total iron binding capacity in microcytic anaemia not caused by iron deficiency?

A

Low total iron binding capacity

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15
Q

What happens to the % saturation of transferrin in iron deficiency anaemia?

A

Low % saturation of transferrin

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16
Q

What happens to the % saturation of transferrin in anaemia of chronic disease?

A

Low % saturation of transferrin

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17
Q

A blood film showing anisopoikilocytosis, target cells and pencil pokilocytes is suggestive of what diagnosis?

A

Iron deficiency anaemia

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18
Q

What are the three main reasons for being iron deficient, leading to anaemia?

A

Blood loss, insufficient nutritional intake, reduced absorption

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19
Q

What diagnosis should always be considered in men or post-menopausal women with iron deficiency anaemia?

A

GI blood loss

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20
Q

What condition is most likely to cause a deficiency of iron absorbed, leading to anaemia?

A

Coeliac disease

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21
Q

What is the treatment for iron deficiency anaemia?

A

Oral ferrous sulphate

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22
Q

How long should ferrous sulphate be taken for when treating iron deficiency anaemia?

A

For 3 months after the deficiency has been corrected

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23
Q

What are some common side effects of taking oral ferrous sulphate?

A

Nausea, abdominal pain, altered bowel habit

24
Q

What are the main causes of megaloblastic macrocytic anaemia?

A

B12 and/or folate deficiency

25
Q

What are the main causes of non-megaloblastic macrocytic anaemia?

A

Alcohol, liver disease, hypothyroidism, pregnancy

26
Q

What are the main causes of spurious (false) macrocytosis?

A

Reticulocytosis and cold agglutinins

27
Q

Vitamin B12 travels down the gut bound to what?

A

Intrinsic factor

28
Q

Where is vitamin B12 absorbed?

A

Terminal ileum

29
Q

What lifestyle choice can lead to an inadequate intake of of vitamin B12?

A

Vegan diet

30
Q

What is the most common cause of vitamin B12 deficiency?

A

Pernicious anaemia

31
Q

Which disease of the bowel is most likely to cause a deficiency of vitamin B12?

A

Crohn’s disease

32
Q

What is the pathophysiology behind pernicious anaemia?

A

An autoimmune destruction of gastric parietal cells resulting in a deficiency of intrinsic factor

33
Q

What lifestyle choice can lead to an inadequate intake of folate?

A

Alcoholism

34
Q

What drugs are recognised as a cause of folate deficiency?

A

Anti-convulsants, particularly phenytoin

35
Q

How long do stores of vitamin B12 last for in the body?

A

2-4 years

36
Q

How long do stores of folate last for in the body?

A

4 months

37
Q

What is the daily requirement of vitamin B12?

A

1.5mcg

38
Q

What is the daily requirement of folate?

A

200mcg

39
Q

Where is folate absorbed?

A

Duodenum and jejunum

40
Q

A sore tongue can be a feature of which type of anaemia?

A

Megaloblastic macrocytic anaemia

41
Q

What neurological problem can vitamin B12 deficiency lead to eventually?

A

Subacute combined degeneration of the cord

42
Q

What cause of anaemia is most likely to cause neurological and neuropsychiatric features?

A

Vitamin B12 deficiency

43
Q

Are the neurological consequences which occur as a result of vitamin B12 deficiency reversible?

A

No

44
Q

A blood film showing macrovalocytes and hypersegmented neutrophils is suggestive of which type of anaemia?

A

Megaloblastic macrocytic anaemia

45
Q

What antibodies can be tested for if pernicious anaemia is suspected as a diagnosis?

A

Anti-GPC and anti-IF

46
Q

How is pernicious anaemia treated?

A

Vitamin B12 injections for life

47
Q

Why should you never give folic acid tablets before treating B12 deficiency, unless the B12 level is known to be normal?

A

This can precipitate subacute combined degeneration of the cord

48
Q

What type of anaemia (i.e. micro, normo, macrocytic) does aplastic anaemia cause?

A

Normocytic

49
Q

What is the most common cause of a normocytic anaemia?

A

Anaemia of chronic disease

50
Q

What happens to the serum iron in anaemia of chronic disease?

A

Low serum iron

51
Q

What happens to the ferritin level in anaemia of chronic disease?

A

Normal or increased serum ferritin

52
Q

What is the congenital cause of aplastic anaemia?

A

Fanconi’s anaemia

53
Q

How is Fanconi’s anaemia inherited?

A

Autosomal recessive

54
Q

Which spinal cord tract is affected first by vitamin B12 deficiency?

A

Dorsal columns

55
Q

If there is no neurological involvement, how is vitamin B12 deficiency treated?

A

1mg IM injection of vitamin B12 3 times weekly for 2 weeks, then once every 3 months