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3 Haematology > Anaemia and Microcytic Anaemia > Flashcards

Anaemia and Microcytic Anaemia Flashcards

1
Q

define anaemia

A

reduced total red cell mass

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2
Q

name surrogate markers of anaemia?

A

haemoglobin conc

haematocrit

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3
Q

normal Hb for men?

A

130-180g/L

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4
Q

normal Hb for women?

A

120-180g/L

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5
Q

why do men have higher Hb levels?

A

more testosterone

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6
Q

haematocrit levels are higher in men or women?

A

men

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7
Q

red cell production occurs where?

A

bone marrow

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8
Q

how do you create a Hb solution?

A

lyse red cells

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9
Q

what is haematocrit?

A

the ratio of the volume of red cells to the total blood volume

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10
Q

when would Hb and haematocrit levels not be a good marker of red cell mass and why?

A

rapid bleeding
if fluids have been given

both cause plasma expansion

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11
Q

how does the body respond to anaemia?

A

increased red cell production

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12
Q

red cells that have JUST left the bone marrow are called…

A

reticulocytes

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13
Q

are reticulocytes or RBCs larger?

A

reticulocytes

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14
Q

what colour do reticulocytes stain and why?

A

purple/blue as they have RNA

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15
Q

“polychromatic blood film”

A

reticulocytes

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16
Q

how is haematocrit calculated?

A

red cell number x red cell volume

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17
Q

what is MCV?

A

size of the red cells (mean cell volume)

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18
Q

what blood test looks at cellular morphology (shape)?

A

blood film

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19
Q

when would you do a reticulocyte count?

A

to assess bone marrow response

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20
Q

2 main causes of anaemia?

A

decreased production

increased loss

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21
Q

what is a marker of decreased red cell production?

A

low reticulocyte count

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22
Q

what is a marker of increased red cell loss?

A

high reticulocyte count

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23
Q

causes of low reticulocyte count?

A

hypoproliferative - reduced erythropoesis

maturation abnormality - ineffective erythropoesis

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24
Q

what can make erythropoesis ineffective?

A

impaired haemoglobinisation

impaired cell division

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25
Q

causes of high reticulocyte count?

A

bleeding

haemolysis

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26
Q

if MCV is low and patient is anaemic what could be the cause?

A

haemoglobinisation problems in the cytoplasm

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27
Q

if MCV is high and patient is anaemic what could be the cause?

A

cell division

got big cells that cant divide

28
Q

iron and porphyrin meet where in the cell to make haem?

A

mitochondrion

29
Q

appearance of microcytic anaemia cells?

A

hypochromic - lack of colour from lack of Hb

small

30
Q

haemoglobin synthesis occurs where?

A

cytoplasm

31
Q

commonest and 2nd most common cause of microcytic anaemia?

A

iron deficiency

thalassaemia

32
Q

define thalassaemia

A

cant make globin chain

33
Q

how does anaemia of chronic disease differ from iron deficiency anaemia in terms of iron levels?

A

normal body iron but lack of available iron

34
Q

its common for porphyrias to cause microcytic anaemia T or F

A

F

35
Q

what kind of poisoning can cause problems with porphyrin synthesis?

A

lead

36
Q

microcytic anaemia is caused by…

A

haemoglobinisation problems

37
Q

macrocytic anaemia is caused by…

A

cell division problems

38
Q

when fully saturated 1g Hb will bind __ml O2

A

1.34

39
Q

how can you work out how much iron is in the blood

A

divide total blood volume by 2

40
Q

storage iron is stored in a molecule called…

A

ferritin

41
Q

circulating iron is bound to what molecule?

A

transferrin

42
Q

what organ is iron stored in mainly?

A

liver

43
Q

how does iron get to red cells?

A

circulate bound to transferrin
transferred to bone marrow macrophages
fed to red cell precursors

44
Q

test for functional iron levels

A

Hb

45
Q

test for transported iron levels?

A

serum iron OR transferrin

46
Q

test for storage iron?

A

ferritin levels

47
Q

what does transferrin transport iron from and to?

A

from macrophages/intestinal cells/hepatocytes to tissues expressing transferrin receptors eg erythroid marrow

48
Q

low ferritin means…

A

iron deficiency

49
Q

causes of iron deficiency

A

diet
blood loss eg menorrhagia/GI
malabsorption

50
Q

men commonly get iron deficiency T or F

A

F, rare and usually pathological

51
Q

how much iron is lost per month from menstrual blood loss? how is this worked out?

A

15-20mg

average period blood loss is 30-40ml and to get iron levels you divide blood vol by 2

52
Q

heavy menstrual blood loss is defined as

A

> 60ml blood loss

53
Q

when do epithelial changes such as skin and koilonychia occur in anaemia?

A

LATE

54
Q

normal MCV values

A

85-105

55
Q

normal transferrin sat is..

A

30%

56
Q

what iron supplement is used? dose and frequency?

A

ferrous fumarate 210mg TDS

57
Q

management plan for man with iron deficiency anaemia and bowel signs

A

colonoscopy

58
Q

how should iron tablets be taken and why?

A

with food as it is absorbed very quickly

with orange juice as acidity transports it better

59
Q

other iron preparations?

A

IV iron

60
Q

risks of IV iron

A

risk of ROS
anaphylaxis
diabetes risk

61
Q

how does iron get into the body?

A

as haem or non-haem iron

62
Q

how much iron is absorbed per week?

A

7g

63
Q

even if iron isnt raised after initiating supplements, what marker can you check to see if the patient is responding to treatment?

A

reticulocytes

64
Q

how long should you treat pernicious anaemia?

A

for life as its an autoimmune condition

give B12 every 3 months

65
Q

3 main SEs of iron supplementation

A

black stool
constipation
abdo pain

3 Haematology (30 decks)

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