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Year 2 Cardio > Anaemia > Flashcards

Anaemia Flashcards

1
Q

What are the 4 mechanisms of anaemia?

A

reduced production of red cells/haemoglobin by the bone marrow

reduced survival of red cells in the circulation (haemolysis).

loss of blood from the body

pooling of red cells in a very large spleen.

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2
Q

What are the three classifications of anaemia? (size)

A

Microcytic
Normocytic
Macrocytic

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3
Q

What are reticulocytes?

A

Early red cells

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4
Q

What is ferritin?

A

Cellular store of iron

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5
Q

What is a classic form of microcytic anaemia?

A

Iron deficiency

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6
Q

What is ESR (process)?

A

Rate at which red cells fall in test tube

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7
Q

What does ESR stand for?

A

Erythrocyte sedimentation rate

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8
Q

Why do rouleaux develop?

A

Increased number of plasma proteins with positive charge
Attract red cells
Stacking of coins

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9
Q

What is anaemia of chronic disease?

A

Characterised by pattern of low-normal transferrin
No obvious cause except that the patient is ill
Diagnosis by exclusion

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10
Q

What is the issues with measuring

A

Not very sensitive measure of iron stores

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11
Q

What causes low MCV?

A

Iron deficiency
Alpha/Beta Thalassemia
Anaemia of chronic disease

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12
Q

What laboratory tests can be conducted to diagnose microcytic anaemia?

A

Iron screening

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13
Q

What comprises an iron screening

A 
Ferritin
Serum iron
Transferrin
Transferrin saturation
Hb electrophoresis
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14
Q

What question should you ask in iron defficency?

A 
Heavy menstrual blood loss
Menopausal and bleeding?
Diet - vegan/vegetarian
GI symptoms: dysphagia
Weight loss
Medication e.g. NSAIDS, asprin
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15
Q

What are features of iron deficiency anaemia?

A

Glossitis
Angular stomatitis
Koilonychia

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16
Q

She reports weight loss, what investigations should you carry out?

A

Investigation for blood in the stool
GI investigations
Coeliac antibody testing

17
Q

What is haemolysis?

A

Breakdown of red blood cells

Shortened lifespan

18
Q

What are causes of inherited haemolytic anaemia?

A

Membrane abnormalities
Abnormal Hb
Metabolic pathways

19
Q

Why is MCV raised in haemolytic anaemia?

A

Reticulocytes are larger

20
Q

What are heinz bodies?

A

Precipitated oxidised haemoglobin

21
Q

What is the cause of haemolytic anaemia on this case?

A

G6PD deficiency

22
Q

What are those with a G6PD deficiency told to do?

A

Avoid oxidant drugs
Don’t eat broad beans
Avoid naphthalene
Be aware that haemolysis can result from infection

23
Q

What is LDH?

A

Is an intracellular enzyme that is leaked into the plasma when cells breakdown

24
Q

What are spherocytes?

A

Smaller RBC’s with loss of central pallor

25
Q

What are the two types of haemolytic anaemia?

A

Inherited

Acquired (normal red cells but environment becomes toxic to the cell)

26
Q

What are the two types of acquired haemolytic anaemia?

A

Non-immune

Immune mediated

27
Q

What test do you do to look for auto-antibodies?

A

Direct antiglobulin test

DAT

28
Q

How does DAT work?

A

Add rabbit antibody that is directed against human immunoglobulin
Binds human immunoglobulin together

29
Q

What is AIHA?

A

Auto immune haemolytic anaemia

30
Q

What causes hereditary spherocytosis?

A

Due to inherited defect in red cell membrane

31
Q

What are polychromatic macrocytes?

A

Blue, large cells
Due to the presence of ribosomes they pick up blue dye
Young cells

32
Q

What is treatment for hereditary spherocytosis?

A

Folic acid

Splenectomy

33
Q

What is meant by inappropriately normal reticulocytes?

A

When Hb is so low you would expect reticulocytosis to compenstae

34
Q

What is a neutrophil with many lobes known as?

A

hyper-segmented neutrophil

35
Q

Why do you always have to check B12 and folic acid blood test?

A

Present exactly the same on blood films

Need to do both to differentiate

36
Q

What is megaloblastic change?

A

Nucleocytoplasmic dissociation

37
Q

What can cause megaloblastic change?

A

Drugs
Folate antagonists e.g. methotrexate
BM cancer

38
Q

What does B12 require to be absorbed?

A

Intrinsic factor

39
Q

What is pernicious anaemia?

A

Destroy cells in stomach

Cannot absorb B12

Year 2 Cardio (10 decks)

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