Anaemia Flashcards
name 2 causes of microcytic anaemia
Iron deficiency
thalaseamiea
Blood film of iron deficiency anaemia. Which cells will be seen
Rod cells (pencil cells)
name 2 causes of macryocytic anaemia (megaloblastic anaemia). WHY is this the case
B12 deficiency and Folate deficiency
- B12 and folate are essential co-factors for nuclear maturation.
microcytic anaemia due to problem with
- cytoplasm
- nucleus
Cytoplasm
Macrocytic anaemia due to problem with
- cytoplasm
- nucleus
Nucleus
- abnormal nuclear maturation (nucleus fails to divide)
Most common cause of B12 deficiency
Pernicious anaemia
Name 4 causes of B12 deficiency
Pernicious anaemia
Vegan
Gastrectomy
Coeliac disease
Where is B12 absorbed
ileum
Where is folate absorbed
Jejunum
Which auto-antibodies do you check for in ?pernicious anaemia
anti Gastric parietal cell
anti Intrinsic factor
How do you manage pernicious anaemia
Vit B 12 injections for life
What is spurious macrocytosis
Name 2 causes
Volume of mature red cells is normal
but MCV is measured as high
Reticulocytosis (bigger than mature cells)
Cold agglutains
Name an example of a normocytic anaemia
Anaemia of chronic disease
Anaemia of chronic disease
- transferrin (increased/reduced)
- serum ferritin (increased/reduced)
Transferrin - reduced
Serum ferritin - increased
Haemolytic anaemia
- microcytic/normocytic/macrocytic
Normocytic
What will blood film of haemolytic anaemia show
Polychromatic red cells
- due to increased reticulocytosis
Heinz bodies makes you think
G6PD deficiency
Which kind of inheritance is G6PD deficiency
X-linked recessive
Microcytic anaemia means
- nucleus problem
- cytoplasm problem
Cytoplasm problem
Macrocytic anaemia means
- nucleus problem
- cytoplasm problem
Nucleus problem
Which kind of anaemia is thalassaemia
Microcytic anaemia
Target cells on blood film suggest (2)
Iron deficiency anaemia
Splenectomy
Rod cells on blood film suggest
Iron deficiency anaemia
Stores of folate / B12 last longer?
B12 - lasts 2-4 years
Folate - lasts 4 months
Name main cause of non-megaloblastic macrocytic anaemia
Alcohol
What is the best autoantibody to check for pernicious anaemia
anti-intrinsic factor antibody
What should you treat first
- B12 deficiency
- folate deficiency
WHY
Treat B12 deficiency first, otherwise you risk sub acute combined degeneration of the cord
Management of pernicious anaemia
Vitamin B12 injections for life (hydroxycobalamin)
- administered every 3 months
MCV in anaemia of chornic disease is typically
Normal - normocytic anaemia
Adult levels of HbA are reached by X months of life?
6-12 months
For oxygen to bind, iron must be in Fe 3+ / Fe 2+ state?
Must be in Fe2+ for oxygen to bind
Oxygen dissociation curve shifts to the right. This means more/less oxygen is bound?
Less oxygen bound so more oxygen delivered to tissues
if 3 alpha Hb genes are missing, what is this called
Alpha thalassaemia - HbH disease
If there are 0 alpha Hb genes, what is this called?
Alpha thalassaemia - Hb barts hydrops foetalis
What is the most severe form of alpha thalassaemia ?
Hb barts hydrops foetalis
Management of beta thalasseamia trait
No management required
Management of beta thalasaemia intermedia
Occasional transfusion
6-24 month old, pale, failure to thrive, splenomegaly, target cells. What is likely diagnosis? and management?
Beta thalassaemia major
Tx: lifelong transfusion
Howell Jolly bodies indicates
Post splenectomy
Bone deformities occur in which type of anaemia
Thalassaemia
What are the 3 main features of haemolytic anaemia
Jaundice
Splenomegaly
Anaemia
patient that turns jaundice and becomes anaemic after eating broad beans, developing an infection or being treated with antimalarials. The underlying diagnosis might be
G6PD deficiency
