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Hugh's Intersystems > Anaemia and Blood Groups > Flashcards

Anaemia and Blood Groups Flashcards

1
Q

What is the major determining factor of whether a person needs a transfusion after an acute drop in Hb?

A

How long that person can maintain a compensatory increase in HR

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1
Q

What are three causes of haemolysis that are external to the RBC?

A

Immune mediated

Mechanical

Infection

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1
Q

If you’re rhesis negative will you have anti-D antibodies?

A

Not unless you’re exposed to D antigen

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2
Q

On a molecular level, what differentiates someone who is blood group A from B from O?

A

The gene they possess determines whether A or B will be added to their H antigen, or neither added in the case of O.

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3
Q

What is the most common enzymatic cause of haemolysis? What is seen on blood film?

A

G6PD deficiency

Blister/bite cells, spherocytes

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4
Q

Macrocytic anaemia with decreased reticulocytes indicates what?

A

B12 or folate deficiency

Alcohol abuse

Cytotoxic agents

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5
Q

How do you test for immune mediated haemolysis?

A

DAT (Coomb’s test)

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5
Q

Thalassemia causes what type of anaemia?

A

Microcytic

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6
Q

What are some signs of increased destruction of RBCs?

A

Jaundice

Decreased Haptoglobins

Increased LDH

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7
Q

What are some major signs of anaemia?

A

Palor

Lethargy

Failure to thrive

Hypoxia

Ischaemia

Tachycardia

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8
Q

What is MCHC?

A

The ratio of MCH to MCV giving the mean Hb per unit of volume of the RBC cell

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9
Q

What is polychromasia? What does it indicate?

A

RBC has RNA therefore it has left the bone marrow prematurely

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10
Q

B12 deficiency causes which type of anaemia?

A

Macrocytic

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11
Q

In what scenario is rhesis status problematic?

A

When a negative mother has a positive child

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12
Q

Which blood group is the most rare?

A

AB ~3%

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13
Q

What happens if the wrong blood group is transfused?

Eg A blood group receiving B blood

A

Immediate catatrophic immune response that is generally fatal

(The recipients antibodies’ attacking the donated RBCs)

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14
Q

Which blood groups are most common?

A

A and O = ~30-40% each

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16
Q

What is dyserythropoiesis?

A

Dysfunctional RBCs

16
Q

What does a bone marrow trephine give you over a bone marrow aspirate?

A

Cellular architecture

17
Q

On which chromosome are the ABO genes located?

A

9

18
Q

What percentage of Australians are rhesis positive?

A

98%

19
Q

Macrocytic anaemia with increase reticulocytes is indicative of what?

A

Haemorrhage

Haemolysis

Response to Fe or B12 treatment

20
Q

What is MCV?

A

Mean corpuscle volume - mean volume of RBCs

21
Q

Liver disease causes which type of anaemia?

A

Macrocytic

22
Q

What is polycythaemia?

A

Too many RBCs

23
Q

What is a membrane cause of haemolysis? What is seen on blood film?

A

Hereditary spherocytosis

Spherocytes

24
Q

What type of blood can O people receive?

A

Only O

25
Q

What type of blood can A people receive?

A

A or O

27
Q

What is the most common cause of microcytic anaemia?

A

Iron deficiency

28
Q

What are some signs of increase production of RBCs?

A

Reticulocytes

Polychromasia

29
Q

What is MCH?

A

The mean amount of Hb per RBC

30
Q

What type of blood can AB people receive?

A

Anything

32
Q

What are some Hb causes of haemolysis? What is seen on blood film?

A

Thalassemias

Sickle cell

Unstable Hb

Sickle cells

33
Q

What are hypochromic RBCs?

A

RBCs without enough Hb

34
Q

What rhesis status must be monitored in pregnant women?

A

Rhesis negative

35
Q

What are some mechanical causes of haemolysis?

A

Sepsis with disseminated intravascular coagulation

Hardware implants

HUS

36
Q

Which responses to steroid therapy, IgG or IgM mediated haemolysis?

A

IgG

38
Q

What are inotropes?

A

Drugs that modulate the force of heart contraction

39
Q

What is the pathogenesis of anaemia of chronic disease?

A

Cytokines produced in the chronically inflamed state; IL-1, IL-6 and TNF-alpha stimulate the liver to produce hepcidin (along with other protein, eg CRP)

Hepcidin inhibits to use of iron from stores causing insufficient haemoglobin to be made.

40
Q

Folate deficiency causes which type of anaemia?

A

Macrocytic

41
Q

How does the CVS respond to an acute drop in Hb?

A

Increase HR

42
Q

How is anaemia measured?

A

Hb concentration

43
Q

What is the equation for tissue oxygen delivery?

A

CO x Hb x %Satn x 1.34

44
Q

How do you diagnosis Thalassemias?

A

Hb electrophoresis

Hugh's Intersystems (15 decks)

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