Anaemia and Bleeding Disorders Flashcards
what does a FBC include
MCV
HCT
RCC
WCC
PLT
what is indicated if more than one blood component is reduced
problem in bone marrow
what is polycythaemia
raised Hb
what is leukocytosis
raised WCC
what is thrombocythaemia
increased platelets
name the two main groups of blood cancer
leukaemia
lymphoma
what is porphyria
abnormality of haem metabolism
what is acute intermittent porphyria
partial deficiency of hydroxymethylbilane synthase caused by medicines such as local anaesthetic
what are clinical effects of acute intermittent porphyria
photosensitive rash
seizures
motor and sensory changes
autonomic disturbances
what are the three steps to diagnosing anaemia
determine if patient has an anaemia
what is the RCC or HCT
what is the MCV
why is the RCC or HCT investigated when diagnosing anaemia
to see whether it is a cell deficiency or if it is a Hb formation deficiency
why is the MCV measured when investigating anaemia
if anaemia is due to bleeding issue or if anaemia is due to formation of abnormal blood cells
what is microcytosis
RBCS smaller on average
what is thalassaemia
smaller RBCs
Fe deficiency
less Hb per cell
What is macrocytosis
RBCs larger on average
what is macrocytosis associated with
folic acid or vit B12 deficiency
why may renal function be examined when investigating anaemia
because RBCs are triggered for release by erythropoietin which is formed in the kidney
4 signs of anaemia
fast HR
tired
SOB
pale and smooth mucosa
what is beefy tongue associated with
vit B12 deficiency
what is occult bleeding
patient isn’t aware they are bleeding internally - examined with endoscopy or colonoscopy
what is the treatment for iron related anaemia
iron tablets 200mg tablets for 3 months
what is the treatment for B12 deficient anaemia
1mg IM injection every six weeks then 1mg every 2 months
what is the treatment for folate related anaemia
5mg folic acid daily
name three ways anaemia could present in the mouth
mucosal atrophy
candidiasis
recurrent ulceration
what is achlorhydria
lack of stomach acid - cannot convert non-haem from 3+ to 2+ valency which is required for absorption
what may be three reasons for vitamin B12 deficiency
problem with intrinsic factor in stomach
problem with dietary intake of vit B12
disease in terminal ileum (crohn’s)
what can be two potential causes for folate deficiency
dietary habits
jejunal disease (Coeliac)
what can deficiencies in folate level be linked to with regards to pregnancy
spina bifida
when is alpha Hb made
throughout life
when is beta Hb made
after birth mainly
when is gamma Hb made
at birth and reduces after
what is sickle cell anaemia
abnormal globin chains due to low O2 concentrations which prevents the RBCs from passing through capillaries and leads to tissue ischaemia
what is the action of clopidogrel
inhibits ADP induced platelet aggregation
what is dipyradmole
inhibits platelets phosphodiesterase
what is INR
time taken for prothrombin to turn into thrombin
what is the action of aspirin
inhibits platelet aggregation by changing the platelet for its lifespan - effect for 7 days
what is warfarin
anticoagulant - taken to inhibit the clotting cascade
does warfarin affect platelets
no - platelets will still form clots but will not stabilise as fibrin will not be deposited on the surface
what is angular cheilitis a sign of
iron deficiency
