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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

what are surrogate markers used to measure red cell mass

A

haemoglobin Hb

haematocrit Hct

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3
Q

For a male, at what levels are you anaemic

A

Hb < 130

Hct 0.38-0.52

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4
Q

For a female, at what levels are you anaemic

A

Hb < 120

Hct 0.37-0.47

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5
Q

Where does erythropoeisis occur

A

bone marrow

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6
Q

what is a macrophage also known as

A

histiocyte

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7
Q

how is Hb concentration measured

A

spectophotometric method

burst RBC to create Hb solution and measure optical density

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8
Q

how do you measure haematocrit

A

ratio/% of the whole blood fluid that is red if it was left to settle

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9
Q

are Hb and Hct always reliable markers of anaemia

A

no

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10
Q

what is the response to anaemia

A

reticulocytosis

sign of increased red cell production

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11
Q

what are reticulocytes

A

immediate precursors of red cells that have just left the bone marrow and entered the bloodstream

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12
Q

features of reticulocytes

A

no nucleus - RNA is present
larger than RBC
purple colour
polychromatic blood film

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13
Q

in terms of red cell parameters, what is measured and what is calculated

A

measured: Hb concentration, number and size of RBCs
calculated: Hct, mean cell Hb, mean cell Hb concentration

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14
Q

in anaemia:

decreased production will have a high/low reticulocyte count

A

low - since bone marrow is not working effectively

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15
Q

in anaemia:

increased destruction and loss of cells will have a high/low reticulocyte count

A

high - since marrow is working to compensate for loss

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16
Q

what are causes of a low reticulocyte count

A

hypoproliferative - decreased erythropoeisis

maturation abnormality - cytoplasmic or nuclear

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17
Q

what defect occurs if there is a cytoplasmic maturation abnormality

A

impaired haemoglobinisation

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18
Q

what defect occurs if there is a nuclear maturation abnormality

A

impaired cell division

19
Q

what is MCV

A

mean cellular volume

20
Q

what is MCV useful for

A

distinguishing between cytoplasmic and nuclear defects

21
Q

what does a low MCV indicate

A

microcytic cells

cytoplasmic defect in haemoglobinisation

22
Q

what does a high MCV indicate

A

macrocytic cells

nuclear defect in maturation

23
Q

in which part of the cell is Hb synthesised

A

cytoplasm

24
Q

what makes up Hb

A

Haem = Fe2+ and Porphyrin

Globin

25
Q

deficiency of what causes small cells with low Hb content

A

low Fe, porphyrin, globin

26
Q

what do microcytic hypochromic cells indicate

A

deficient Hb synthesis from cytoplasmic defect

27
Q

what are causes of haem deficiency

A

iron deficiency
anaemia of chronic disease
abnormal porphyrin synthesis
congenital sideroblastic anaemia

28
Q

what are causes of globin deficiency

A

thalassaemia

29
Q

how can iron exist in the body

A

Fe2+ –> ferrous state

Fe3+ –> ferric state

30
Q

what are the functions of iron

A

carry O2 in Hb and myoglobin
transport electrons in mitochondria
generate free radicals (dangerous)

31
Q

In iron studies: what tests for functional iron

A

Hb levels

32
Q

in iron studies: what tests for transported iron

A

serum iron
transferrin
transferrin saturation

33
Q

in iron studies: what tests for storage iron

A

serum ferritin

34
Q

what is transferrin

A

protein with 2 binding sites for iron atoms which transfers iron from donor tissue to cells expressing transferring receptors

35
Q

what is % transferrin saturation with iron

A

measurement of iron supply

36
Q

Iron deficiency and anaemia of chronic disease cause high/low %transferrin saturation

A

low

37
Q

haemochromatosis causes high/low %transferrin saturation

A

high

38
Q

what is ferritin

A

large intracellular storage protein that stores Fe3+

39
Q

what happens to ferritin if there is an increase in iron levels

A

ferritin levels go up

40
Q

low ferritin means there is iron deficiency, true or false

A

true

41
Q

what is an indirect measure of storage iron

A

serum ferritin

42
Q

what are causes of iron deficiency

A

insufficient dietary intake
haemorrhage - menorrhagia, GI, haematuria
malabsorption - coeliac, crohns

43
Q

where is iron absorbed in the GI tract

A

proximal gut

44
Q

what is needed to help iron absorption

A

acid

Haematology (26 decks)

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