Anaemia Flashcards
What is the normal MCV range (outside of which is abnormal)?
80-100
What investigation would you do after finding microcytic anaemia?
Serum iron studies & Mentzer index (MCV/RBC)
What investigation would you do after finding normocytic anaemia?
Reticulocyte count
What investigation would you do after finding macrocytic anaemia?
Megalocytes and segmented neutrophils on peripheral smear (i.e. finding out if it is megaloblastic or not)
What does microcytic anaemia + low iron and ferritin with high TIBC indicate?
Iron deficiency anaemia
What does microcytic anaemia + low/normal iron and ferritin with low TIBC suggest?
A component of anaemia of chronic disease with iron deficiency anaemia
What does a Mentzer index < 13 with microcytic anaemia indicate?
Thalassaemia
What does low reticulocyte count < 2% (hypoproliferative) normocytic anaemia indicate?
Marrow failure syndromes
- Leukaemias
- Aplastic anaemia
- Pure red cell aplasia
What does high reticulocyte count > 2% (hyperproliferative) normocytic anaemia indicate?
- Haemolytic anaemias
- Haemorrhage
What are types of haemolytic anaemias?
1) Sickle cell anaemia
2) Thalassaemia
3) G6PD deficiency
4) Haemolytic disease of the newborn
5) Blood transfusion reaction
6) Autoimmune e.g. SLE, lymphoma, CLL, mono/EBV, mycoplasma, drug-related
7) Non-immune
What are non-immune causes of haemolytic anaemia?
1) Trauma - leading to disseminated intravascular coagulation or haemolytic uraemic syndrome and thrombotic thrombocytopenic purpura
2) Infection - malaria, sepsis
What are causes of megaloblastic macrocytic anaemia?
1) Vitamin B12 and/or folate deficiency
2) Drug-induced
What are causes of non-megaloblastic macrocytic anaemia?
- Alcohol abuse
- Myelodysplastic syndrome
- Liver disease
- Congenital bone marrow failure syndromes
What is the MCV in anaemia of chronic disease (secondary anaemia)?
Normocytic or microcytic
What are the 3 causes of iron-deficiency anaemia?
- Blood loss
- Poor diet
- Malabsorption
