Anaemia: Approach to diagnosis Flashcards
What is are the 2 definitions of anaemia?
- Reduction in Hb conc below which is optimum for that person
- Reduction in Hb conc below 95% range for the population
A Hb conc in a child 6 months to 6 years where aneamia is likely to be present?
110
A Hb conc in a child aged 6-14 years where anaemia is likely to be present?
120
A Hb conc in an adult where anaemia is present?
Male - 130
Female (non-pregnant) - 120
Female (pregnant) - 110
What is hypoproliferative?
Reduced amount of eryhtropoiesis
What happens in a Maturation abnormality?
Erythropoiesis present but ineffective
What are cytoplasmic defects?
Impaired haemoglobinisation
What are nuclear defects?
Impaired cell division
What is the most common cause of hypochromatic microcytic anaemia?
Iron deficiency
What are causes of microcytic anaemia?
Thalassaemia
Lead poisoning
Pyridoxine responsiveness anaemias
Sideroblastic anaemia
What are causes of macrocytic anaemia?
Folate dysplasia B12 deficiency Myelodysplasia Myeloma Aplastic anaemia Reticulocytosis Cold agglutinins
What happens to epo production in most cases of renal failure?
Goes down
What can cause macrocytosis without anaemia?
Alcohol
Liver disease
Hypothyroidism
What can cause Normochromic normocytic anaemia?
Acute blood loss/early iron deficiency. Hypoproliferative(low retic) - Chronic illneses - Anaemia of renal failure - Hypometabolic states Marrow failure
Describe anaemia of chronic diseases?
A multifactorial pathophysiology with inflam a central process
What happens in anaemia of chronic disease?
Blunted epo response by kidney
Impaired iron availability to erythroid precursors
Inhibition of erythroid precursor proliferation and differentiation
Reduced red cell survival
What is anaemia of chronic disease driven by?
Inflammatory cytokines induced by infection/malignancy/autoimmune disease dysregulaiton
What happens to Serum iron with regards to a) iron deficiency and b) anaemia of chronic disease?
a) Reduced
b) Reduced
What happens to Transferrin with regards to a) iron deficiency and b) anaemia of chronic disease?
a) Normal or Increased
b) Normal or Reduced
What happens to % Transferrin saturation with regards to a) iron deficiency and b) anaemia of chronic disease?
a) Reduced
b) Reduced
What happens to Ferritin with regards to a) iron deficiency and b) anaemia of chronic disease?
a) Reduced
b) Normal or Increased
What happens to MCV with regards to a) iron deficiency and b) anaemia of chronic disease?
a) Reduced (can be normal)
b) Normal (can be reduced)
