Anaemia: Approach and Diagnosis

Question 1

normal Hb conc for 6-14 year olds?

Answer 1

120g/L

Question 2

normal Hb conc for 6 months to 6 year-olds?

Answer 2

110

Question 3

what are haematinics?

Answer 3

B12
folate
ferritin

Question 4

Ix anaemia

Answer 4

FBC
retic count
blood film
haematinics

BM biopsy
Hb electrophoresis etc

Question 5

useful marker of red cell production?

Answer 5

retic count

Question 6

if there is a high retic response but anaemia is present, what could be the cause?

Answer 6

destructive problem eg haemolysis or bleeding

Question 7

if a reticulocytosis is present what other things should you look for?

Answer 7

red cell breakdown products

Question 8

if red cells are normocytic and normochromic but there is anaemia. what could be the cause?

Answer 8

hypoproliferative (just not making red cells):
chronic disease
hypometabolic eg hypothyroid
marrow failure
renal failure (cant make EPO)

Question 9

what is MCH?

Answer 9

cell Hb content

Question 10

causes of macrocytic anaemia that is NOT due to B12/folate deficiency

Answer 10

myelodysplasia
myeloma
aplastic anaemia
reticulocytosis

Question 11

what can cause macrocytosis without anaemia?

Answer 11

alcohol
liver disease
hypothyroidism

Question 12

kidneys make EPO in response to..

Answer 12

HYPOXIA

Question 13

marker of anaemia of chronic disease?

Answer 13

hepcidin (increased hepcidin blocks iron deposition)

Question 14

what part of the kidney releases EPO

Answer 14

juxtaglomerular apparatus

Question 15

Tx ACD

Answer 15

IV iron

Question 16

MCV is ___ inACD

Answer 16

normal

Question 17

why arent loads of retic counts done?

Answer 17

msot anaemias are hypoproliferative

Question 18

what marker can be normal in an iron deficient patient that you would expect to be low?

Answer 18

MCV

Question 19

high ferritin can also be a sign of..

Answer 19

acute phase reaction