Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FHHD > Anaemia > Flashcards

Anaemia Flashcards

1
Q

What is the life span of a RBC

A

4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the structure of Haemoglobin

A

2 alpha protein chains
2 beta protein chains
Each chain has an Fe2+ and a heme group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is anaemia

A

Low Hb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 3 mechanisms that can result in anaemia

A
  • Decreased production of red cells
  • Increased destruction of red cells
  • Loss of red cells - bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can cause the decreased production of red cells in anaemia

A
  • iron deficiency
  • B12 or folate deficiency
  • Marrow infiltration e.g. cancer
  • Any chronic disease e.g. rheumatoid, cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What classifications of anaemia are there

A
  • Inherited or Acquired
  • Microcytic, Microcytic, Normocytic
  • Immune or Non-immune
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How big are micro, normo and microcytic RBCs

A 
<76fl = microcytic
76-96fl = normocytic
>96fl = macrocytic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does anaemia caused by defective Hb synthesis result in

A

RBCs that are small - microcytic

And contain reduced amounts of Hb - hypochromic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What factors can help to enhance iron absorption

A
  • Haem iron (meat)
  • Ferrous salts (Fe2+)
  • Acid pH
  • Iron deficiency
  • Pregnancy
  • Hypoxia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What factors impair iron absorption

A
  • Non-haem iron (veg)
  • Ferric salts (Fe3+)
  • Alkaline pH
  • Iron overload
  • Inflammatory disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the basic histology (or morphology? idk) of normal blood cells

A
  • Red cells
  • Uniform size
  • Pale centre
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the basic histology (or morphology? idk) of iron deficient blood cells

A
  • Red cells
  • Variable size
  • Small
  • Pale
  • Target cells, pencil cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What allows you to confirm iron deficiency

A
  1. FBC
  2. Blood film
  3. Decreased serum ferritin (storage iron)
  4. Decreased serum iron and increased total iron binding capacity (TIBC) (not used as often now)
  5. Transferrin saturation (iron/TIBC x 100%) <15% iron deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

AY BAWS CAN I HABE DE NOTE PLZ

A

Iron deficiency is not a diagnosis: find the cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What treatments are there to replace iron

A

Diet?
Oral iron is best
Avoid blood transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What disorder does iron deficiency look like

A

Thalassaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the risk factors for anaemia with normal MCV

A
  • Acute blood loss
  • Chronic disease
  • Cancer
  • Renal disease
  • Haemolysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are some risk factors for anaemia by marrow infiltration

A
  • Metastatic cancers
  • Myeloma
  • Myelofibrosis
  • Leukaemia and lymphoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the mechanism of anaemia from chronic disease

A
  • Reduced RBC lifespan
  • Poor marrow response to Epo
  • Depressed erythropoiesis
  • Inflammatory cytokines (e.g. IL-1, TNF-alpha) - interfere with Epo production and actions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What iron findings and Blood findings are usually found in anaemia of chronic disease

A
  • Hb 7-11g/dL
  • MCV normal
  • Serum iron - low
  • TIBC - low
  • Ferritin - high
  • Blood film - not helpful
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What deficiencies are found in microcytic anaemia

A

Vit B12 or Folate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Vit B12 and folate used for and why does it lead to macrocytic RBCs

A

used for DNA synthesis, without it = DNA synthesis impaired and cells fail to divide = large cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Where is vitamin B12 found

A

Meat, eggs, animal proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where is folate found

A

liver, greens, yeast - destroyed by cooking

25
Q

AY BAWS CAN I HABE DE NOTE PLZ

A

B12 and folate deficiencies look identical

26
Q

What changes in biochemistry can be seen from B12 and folate deficiencies

A

Increased Lactate dehydrogenase

Increase bilirubin

27
Q

What can cause gastric malabsorption of B12 deficiency

A

Pernicious anaemia

Total/partial gastrectomy

28
Q

What can cause intestinal malabsorption of B12 deficiency

A
  • Stagnant loop syndromes
  • Ileal disease
  • Crohn’s
  • Fish tapeworm
29
Q

What is pernicious anaemia, what causes it and what does it lead to

A

Autoimmune disorder where an autoantibody against the gastric mucosa and intrinsic factor (IF) leads to gastric atrophy, decreased acid and IF secretion

30
Q

What are the clinical features of pernicious anaemia

A
  • Insidious (fatal untreated)
  • Anaemia
  • Glossitis
  • Mild jaundice
  • Neurological: peripheral neuropathy, post and alt column damage, dementia, optic atrophy
31
Q

What prescription is given to patients with pernicious anaemia

A

Intramuscular B12 every 3 months for life

32
Q

What causes of folate deficiency are there

A
  • Old age, poverty, alcoholism
  • Coeliac, Crohn’s
  • Pregnancy, lactation, haemolytic anaemias, psoriasis
  • Anticonvulsants, antifolate drugs
33
Q

What are the clinical features of folate deficiency

A
  • Insidious
  • Anaemia
  • Glossitis
  • Mild jaundice
  • No neurology
34
Q

What prescription is given for folate deficiency

A

Oral Folic acid

35
Q

What causes haemolytic anaemias

A

Shortened RBC survival

36
Q

What RBC abnormalities can lead to haemolysis

A

Membrane
Haemoglobin
Enzymes

37
Q

What membrane abnormalities can case haemolytic anaemias

A
  • Hereditary Spherocytosis

- Antibodies against RBC membrane - autoantibodies, alloantibodies

38
Q

What haemoglobin abnormalities can cause haemolytic anaemias

A
  • Abnormal structure (sickle cell)

- Imbalance in synthesis? (thalassaemia)

39
Q

What enzyme abnormalities can lead to haemolytic anaemias

A

Glucose-6-phosphate dehydrogenase deficiency

40
Q

How does haemolytic anaemia present

A
  • Pallor and anaemia
  • Jaundice
  • Gallstones
  • Splenomegaly
41
Q

What lab investigations can be found in a patient with red cell breakdown

A
  • Increased serum unconjugated bilirubin
  • Increased urobilinogen
  • Increased serum lactate dehydrogenase
42
Q

What lab investigations can be found in patients with hereditary spherocytosis

A
  • Spherocytes in peripheral blood
  • Decreased Hb
  • Increased Lactate dehydrogenase
  • Increase unconjugated serum bilirubin
43
Q

What does G6PD enzyme do

A

Reverse the oxidation of Hb and membrane etc

44
Q

What kind of inheritance does hereditary spherocytosis show

A

Autosomal dominant

45
Q

What kind of inheritance does G6PD deficiency show

A

X linked

46
Q

What clinical features does G6PD deficiency show

A

Neonatal jaundice

Acute haemolysis with oxidant drugs or fava beans

47
Q

What happens when oxygen conc decreases in Sickle cell patients

A
  • Hb forms long rod structures
  • RBCs sickle
  • Increased rigidity
48
Q

What major problem occurs as a result of sickle celled RBCs

A

The cells block the microcirculation and this leads to ischaemia and pain

49
Q

What causes autoimmune haemolytic anaemia

A
  • Self reacting IgG antibody that attached to RBC and is removed by the spleen via extravascular haemolysis
50
Q

How do you prove that there is an antibody on an RBC

A

Direct Coombs test/Direct antiglobulin test:

  • Blood sample from a patient with immune mediated haemolytic anaemia and antibodies are shown to be attached to the RBC surface
  • The patient’s washed RBCs are incubated with antihuman antibodies (coombs reagent)
  • RBCs agglutinate: antihuman antibodies form links between RBCs by binding to human antibodies on the RBCs
51
Q

What are some of the causes of immune haemolytic anaemia

A
  • Drugs - Methyldopa, Penicillin
  • Connective Tissue Disease - SLE and RA
  • Cancer e.g. lymphoma
  • Blood transfusion
52
Q

What examinations should be done in order to investigate anaemia

A
  • History + examinations - Drugs, family, lymph nodes, hepatosplemegaly, weight loss, sweats
  • Repeat FBC and ask for blood film
  • Check serum B12, folate and ferritin
  • Renal and liver function
  • ESR - non-specific, general inflammation/chronic disease
53
Q

What are some of the potential underlying causes of microcytic anaemias

A
  • Fe deficiency

- Thalassaemia

54
Q

What are some of the potential underlying causes of normocytic anaemias

A
  • Acute blood loss
  • Chronic disease
  • Cancer
  • Renal disease
  • Haemolysis
55
Q

What are some of the potential underlying causes of microcytic anaemia

A
  • B12/Folate deficiency
  • Alcohol
  • Drugs
  • Liver Disease
  • Bone marrow failure
  • Myelodysplasia
  • Haemolysis
56
Q

What effects does iron deficiency have on RBCs

A

Leads to reduced RBC maturation as Iron required to haem synthesis and therefore reduced haemoglobin

57
Q

What effects does B12/folate deficiency have on RBCs

A

B12 and folate required for DNA synthesis, deficiency leads to impaired maturation of the RBC nucleus causing megaloblastic, macrocytic anaemia

58
Q

Describe the lab features of Haemolytic anaemia

A
  • Increased Reticulocytes
  • Increased LDH
  • Increased bilirubin (unconjugated)
  • Increased urinary B
  • Haptoglobin
  • DAT positive (in immune mediated)

FHHD (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions