Anaemia- Basics

Question 1

What is anaemia defined as? (Include values)

Answer 1

decrease in haemoglobin in blood below reference level for the age and sex of the individual

• Hb <130g/L in adult males (Hct <0.38) and Hb <120g/L in adult females (Hct <0.37)

Question 2

What is the normal response to anaemia?

Answer 2

Reticulocytosis- more red cells made

Question 3

What is a reticulocyte?

Answer 3

Immature RBC that’s just been released from bone marrow
Bit larger than a normal RBC as they still contain some RNA

Question 4

How is reticulocyte count used to classify anaemia?

Answer 4

Low reticulocyte count- decreased production
This can indicate reduced or ineffective erythropoiesis, impaired haemoglobinisation, impaired cell division

High reticulocyte count- increased loss or destruction
This can indicate bleeding or haemolysis

Question 5

How does anaemia generally present?

Answer 5

Non specific systemic symptoms such as fatigue, SOB, headaches, pallor, palpitations and feeling faint

May also be tachycardic, and have a systolic flow murmur

Question 6

What are the investigations for anaemia?

Answer 6

FBC, used to measure:
Hb concentration (confirms diagnosis)
MCV (confirming whether its microcytic or macrocytic)
Haematocrit- (ratio of whole blood that is red cells, low shows anaemia)

Blood film, used to look at cell morphology

Reticulocyte count- assesses bone marrow response

Question 7

If MCV is low, what would you consider?

Answer 7

Microcytic anaemia

Problems with haemoglobinisation

Question 8

If MCV is high, what would you consider?

Answer 8

Macrocytic anaemia

Consider issues with cell division, ie maturation