Anaemia Flashcards
In terms of red cells, what does a high unconjugated bilirubin suggest? Why?
It indicates haemolysis as when red cells breakdown one of the products is unconjugated bilirubin
In terms of red cells, what does a high conjugated bilirubin suggest? Why?
A problem in the liver, if it was to do with red cells the bilirubin would be unconjugated, conjugation of bilirubin occurs in the liver
Is LDH intra or extra cellular?
Intracellular
In relation to reticulocytes, what is the normal response in anaemia?
Increase the production of reticulocytes, those with anaemia should have a high reticulocyte count
What does anaemia with low reticulocytes indicate?
There is a problem with RBC production
What are indicators of haemolysis when looking at bloods?
High unconjugated bilirubin
Raised LDH
Reduced haptoglobulins
What are the 4 mechanisms of anaemia?
Reduced production of RBCs
Increased clearance of RBCs in circulation
Blood loss
Pooling of cells in the spleen
What are some causes of reduced red cell survival?
Hereditary spherocytosis
G6PD deficiency
Autoimmune haemolytic anaemia
What are some causes of reduced red cell production?
Anaemia of chronic disease
Iron deficiency anaemia
Megaloblastic anaemia
How does chromia of red cells differ when cells are macrocytic vs normocytic vs microcytic
Microcytic: hypochromia
Normocytic: normochromia
Macrocytic: normochromia
What are the common causes of microcytic anaemia?
Deficiency in haem synthesis (iron deficiency anaemia or anaemia of chronic disease)
Deficiency in globin synthesis (alpha or beta thalassaemia)
How can we differ between anaemia of chronic disease and iron deficiency anaemia?
Ferritin will be high in chronic but low in iron deficiency, transferrin will be normal/low in chronic but high in iron deficiency
How does electrophoresis allow us to differentiate between alpha and beta thalassaemia?
In alpha thalassaemia, the HbA2 will be normal but in beta it will be raised
How do we differentiate between iron deficiency anaemia and thalassaemia?
Haemoglobin will be low in iron deficiency but normal an thalassaemia, RBC will be low in iron deficiency but raised in thalassaemia
What are common causes of macrocytic anaemia?
Vitamin B12 and folic acid deficiency
Drugs that interfere with DNA synthesis
Liver disease and ethanol toxicity
Haemolytic anaemia
What are some common causes of normocytic anaemia?
Recent blood loss
Failure of production red cells
Pooling of red cells in the spleen
Define haemolysis
Destruction of red cells
What is the lifespan of a normal red cell?
150 days
What pathway provides energy to red cells?
The glycolytic pathway
What enzyme is involved in the glycolytic pathway? How is it significant?
G6PD enzyme, it is rate limiting
How is G6PD deficiency inherited?
X linked recessive (mainly present in men)
What occurs relating red cells when there is G6PD deficiency?
Haemolysis
How will MCV be affected if there are lots of reticulocytes?
It will increase as reticulocytes are larger than RBCs
How do RBCs and reticulocytes compare in terms of size?
Reticulocytes are larger
What will you see on a blood film of someone with G6PD deficiency?
Hyperchromatic cells
Abnormally shaped cells
Heinz bodies
Ghost cells
What are heinz bodies and how do they form?
Haemoglobin is subject to oxidative damage and becomes precipitated and oxidised, causing it to clump together