Anaemia - Data Interpretation

Question 1

Describe the presentation of megablastic anaemia?

Answer 1

• Parasthesia
• Peripheral sensory neuropathy
• Tired
• Sore tongue

Question 2

What is seen in the FBC and blood film for megablastic anaemia?

Answer 2

• Bloods
  
  • Low Hb
  • High MCV
  • Low WBC
  • Low Plts
• Film
  
  • Oval macrocytes
  • Neutrophil hypersegmentation

Question 3

What is done to confirm diagnosis in megablastic anaemia?

Answer 3

• Serum B12 and folate levels

Question 4

What is done to confirm diagnosis of pernicious anaemia?

Answer 4

• Anti-intrinsic factor antibodies

Question 5

Describe the treatment for pernicious anaemia?

Answer 5

• IM vitamin B12
  
  • Cannot absorb oral B12 without intrinsic factor

Question 6

Describe the presentation of hypochromic microcytic anaemia?

Answer 6

• Tired
• Difficulty concentrating
• Irritability with friends
• Breathless on exercise
• Looks pale

Question 7

What is seen in the FBC and blood film for hypochromic microcytic anaemia?

Answer 7

• Bloods
  
  • Low Hb
  • Low MCV
  • Low MCH
  • Normal WBC
  • High Plts
• Blood film – shows morphological description
  
  • Pale cells
  • Small cells

Question 8

What test is done to investigate cause of hypochromic microcytic anaemia?

Answer 8

• Ferritin levels

Question 9

If someone is found to have iron deficiency anaemia, what questions should be asked?

Answer 9

• Bleeding – menorrhagia
• Pregnancy
• Diet
• GI symptoms
  
  • Possibly refer for GI investigations – especially if a man even with no symptoms to find out why iron is low as GI tract most common place

Question 10

Describe the treatment for iron deficiency anaemia?

Answer 10

• Oral iron

Question 11

Describe the presentation of normochromic normocytic anaemia?

Answer 11

• Tired
• Yellow eyes

Question 12

What is seen in the FBC and blood film for normochromic normocytic anaemia?

Answer 12

• Bloods
  
  • Low Hb
  • Normal MCV
  • Normal MCH
  • Normal WCC
  • Normal platelets
• Blood film
  
  • Spherocytes

Question 13

What investigations can be done to confirm diagnosis in normochromic normocytic anaemia?

Answer 13

• Bilirubin (indirect),, LDH
  
  • Breakdown of red cells
• Reticulocyte count
  
  • Bone marrow function
• Serum haptoglobin
  
  • Breakdown of red cells
• DAGT (Coombs test)
  
  • Working out why spherocytosis on film
  • Tells us if patient has antibodies on surface of cell – could be autoantibody (against your own cells) or alloantibody (against red cells that are not yours)

Question 14

What is DAGT?

Answer 14

Coombs test

• Tells us if patient has antibodies on surface of cell – could be autoantibody (against your own cells) or alloantibody (against red cells that are not yours)

Question 15

What does a positive Coombs test mean?

Answer 15

If DAGT is positive:

• Autoimmune haemolysis

Question 16

Describe the presentation of sickle cell disease?

Answer 16

• Jaundice
• Pain in left chest
• Breathless
• Fever

Question 17

What is seen on the FBC and blood film for sickle cell disease?

Answer 17

• Bloods
  
  • Low Hb
  • Normal MCV
  • Normal MCH
  • Normal WCC
  • High platelets
• Blood film
  
  • Sickle cells

Question 18

What confirms diagnosis of sickle cell disease?

Answer 18

• Haemoglobinopathy screen
  
  • Confirms diagnosis of sickle cell disease

Question 19

Describe the management of a painful sickle cell crises?

Answer 19

• Analgaesia
• Oxygen
• Fluids
• Antibiotics if fever
• Thromboprophylaxis
• Blood transfusion
  
  • Indications – severe anaemia, stroke or chest crises