Anaemia introduction

Question 1

What are the 2 pathways of anaemia?

Answer 1

Decreased production
Increased destruction

Question 1

What is anaemia?

Answer 1

This is a condition characterised by a reduced total red cell mass

Question 2

What is the classification of anaemia in males?

Answer 2

Hb < 130g/L
OR
Haematocrit < 0.38

Question 3

What is the classification of anaemia in females?

Answer 3

Hb < 120g/L
OR
Haematocrit < 0.37

Question 4

What are the main 2 measurements used in diagnosis of anaemia?

Answer 4

Haemoglobin concentration
Haematocrit

Question 5

What is the method for measuring haemoglobin concentration?

Answer 5

1. RBCs are burst
2. Cyan-MetHb is used to stabilise Hb molecules
3. Optical density is measured at 540nm
4. This is proportional to the concentration of Hb (Beer’s law)
5. Hb concentration is then calculated against known reference standards of cyan-metHb concentration solution

Question 6

How is haematocrit calculated?

Answer 6

Haematrocrit is measured by centrifuging the blood products and measuring the red layer that forms as a percentange of the total blood volume

Question 7

What are some cases in which haematocrit is not a good measure of anaemia?

Answer 7

If fluid is given, as this expands the plasma, but not the red cell count, so the red cell percentage will be decreased

Question 8

How will decreased RBC production affect reticulocyte number?

Answer 8

There will be a decrease in reticulocyte production so number will decrease

Question 9

How will increased RBC destruction affect reticulocyte number?

Answer 9

There will be an increase in reticulocytes (Reticulocytosis) to compensate for the loss of blood cells

Question 10

What cell is shown here?

Answer 10

Reticulocytes

Question 11

Why do reticulocytes stain purple on blood film?

Answer 11

The have remnants of RNA in their cytoplasm

Question 12

How long will a change in reticulocyte count take in anaemia?

Answer 12

A few days

Question 13

What are the main 2 causes of increased RBC destruction in anaemia?

Answer 13

Haemolysis
Blood loss

Question 14

What is the main way of classifying anaemia?

Answer 14

Based on MCV (Mean Cellular Volume)
- Macrocytic (High MCV)
- Normocytic (Normal MCV)
- Microcytic (Low MCV)

Question 15

What is the main problem causing microcytic anaemia?

Answer 15

Problems with haemoglobinisation

Question 16

What is the main problem causing macrocytic anaemia?

Answer 16

Problems with cell division and maturation

Question 17

What are some general symptoms of anaemia?

Answer 17

• Tiredness
• Shortness of breath
• Headaches
• Dizziness
• Palpitations
• Worsening of other conditions (e.g. angina, heart failure)

Question 18

What are some general signs of anaemia?

Answer 18

• Pale skin
• Conjunctival pallor
• Tachycardia
• Raised respiratory rate

Question 19

What are some causes of normochromic normocytic anaemia?

Answer 19

This is usually caused by hypo proliferation, caused by:
- Marrow failure - Drug induced, aplastic anaemia
- Hypometabolic
- Marrow infiltration
- Renal impairment
- Chronic disease