Anaemia - General Flashcards

1
Q

What are the main groups of causes of anaemia?

A

Deficiency in:

  • Production - Bone marrow
  • Destruction - blood loss, haemolysis
  • Structure and function - membrane, enzymes, haemoglobin
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2
Q

What is anaemia?

A

Defined as low haemoglobin (Hb) concentration - may be due to low red cell mass or increased plasma volume

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3
Q

What are symptoms of anaemia?

A

Reflective of underlying cause, or anaemia itself:

  • Fatigue
  • Dyspnoea
  • Faintness
  • Palpitations
  • Headache
  • Tinnitus
  • Anorexia
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4
Q

What symptoms might someone experience if they have anaemia with pre-existing cardiovascular disease?

A

Worsening:

  • Angina
  • Intermittent Claudication
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5
Q

What signs can occur in anaemia?

A
  • Generalised/Conjunctival Pallor
  • Tachycardia
  • Hyperdynamic apical impulse
  • ESM over apex
  • Signs of Cardiac Failure
  • Koilonychia - Iron deficiency anaemia
  • Vitiligo - pernicious anaemia
  • Jaundice - haemolytic anaemia
  • Bone deformities - Thalassemia major
  • Leg ulcers - sickle cell anaemia
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6
Q

What signs might you see which would point towards a diagnosis of iron deficiency anaemia?

A

All in very long standing disease

  • Koilonychia
  • Brittle nails/hair
  • Atrophy of the papillae of the tongue
  • Angular stomatitis
  • A syndrome of dysphagia and glossitis
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7
Q

What signs might be seen in pernicious anaemia and anaemia caused by B12 deficiency?

A
  • Lemon-yellow skin colour
  • Glossitis
  • Angular stomatitis
  • Vitiligo
  • Jaundice
  • Paraesthesiae
  • Peripheral Neuropathy
  • Neuropsychiatric problems
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8
Q

What are the main types of anaemia?

A
  • Microcytic hypochromic anaemia
  • Normocytic, normochromic anaemia
  • Macrocytic, hyperchromic anaemia
  • Aplastic Anaemia
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9
Q

Top 7 causes…

What are causes of normochromic, normocytic anaemia?

A
  1. Acute blood loss
  2. Anaemia of Chronic Disease (70%)
  3. Bone marrow failure
  4. Renal Failure
  5. Hyperthyroidism
  6. Haemolysis
  7. Pregnancy
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10
Q

What type of anaemia can occur in haemolytic anaemias?

A
  • Normochromic, normocytic anaemia
  • Hyperchromic, macrocytic anaemia
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11
Q

What red cell indices are used to determine the type of anaemia that is occuring?

A
  • Mean cell volume (MCV) - micro/normo/macrocytic
  • Mean cell haemoglobin (MCH) - chromic part - represents haemoglobin concentration which gives blood cell colour
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12
Q

When would you consider giving blood transfusions?

A

If there is severe acute anaemia - tranfusion not necessary in those who have a Hb >70g/L. If there is acute haemorrhage, this limit is generally set at >80g/L

Chronic anaemia is better tolerated

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13
Q

How would you investigate someone who presented with symptoms of anaemia?

A
  • Red cell indices
  • WBC count
  • Platelet count
  • Reticulocyte count
  • Blood film
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14
Q

What are causes of microcytic hypochromic anaemia?

A

In order or most common to least:

  1. Iron deficiency anaemia
  2. Anaemia of Chronic Disease (30%)
  3. Thalassaemia
  4. Sideroblastic anaemia

Remember TAILS - Thalassemia, Anaemia of CD, Iron deficiency, Lead poisoning, Sideroblastic

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15
Q

What are causes of hyperchromic, macrocytic anaemia?

A
  1. B12/Folate Deficiency
  2. Alcohol excess/liver disease
  3. Reticulocytosis
  4. Cytotoxics
  5. Myelodysplastic syndromes
  6. Marrow infiltration/Myeloma
  7. Hypothyroidism
  8. Myeloproliferative disorder
  9. Aplastic anaemia
  10. Anti-folate drugs (e.g phenytoin)
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