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Haematology > Anaemia Overview > Flashcards

Anaemia Overview Flashcards

1
Q

Definition of anemia

A

Reduction in O2 carrying capacity of the blood

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2
Q

Define anemia in adult males according to WHO standard

A

Hb less than 13g/dl in adult males

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3
Q

Define anemia in adult females according to WHO standard

A

Hb less than 12g/dl

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4
Q

Define anemia in children according to WHO standard

A

Hb less than 12g/do (6-14yrs)

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5
Q

Define anemia in neonates according to WHO standard

A

Hb less than 13.5g/dl

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6
Q

Ambient O2 may be affected by altitude T/F

A

T

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7
Q

Ventilation may be affected by

A

Poor ventilation perfusion ratio and anatomical dead space

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8
Q

What is the O2 tension of blood

A

20 volume%

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9
Q

In the arterial blood, O2 tension is approximately

A

20 vol%

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10
Q

In the venous blood, O2 tension is approximately

A

15 vol%

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11
Q

Arteriovenous O2 difference equals

A

5 vol%

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12
Q

Anemia tends to reduce arterio-venous O2 difference T/F

A

T

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13
Q

List the 4 adaptations to anemia

A
  1. Modulation of Hb O2 affinity
  2. Redistribution of blood flow
  3. Increase CO
  4. Reduction of venous O2 tension to increase Arterio-venous O2 difference
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14
Q

To modulate O2 affinity, what compound is increasingly produced to bind and stabilize Hb in its DEOXY form?

A

2,3 DPG

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15
Q

The Hb on red cells during anemia is (pH)

A

Alkaline

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16
Q

Alkalosis stimulates the production of what enzyme

A

1,3 DPG mutase

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17
Q

The modulation of O2 affinity promotes what pathway

A

Rapapport-Lueberig shunt of amended-Myerhoff pathway

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18
Q

1,3 DPG mutase converts 1.3 DPG to

A

2,3 DPG which binds and stabilizes Hb in its deoxy form allowing O2 to be delivered to the tissues.

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19
Q

Other conditions associated with increased 2,3 DPG production

A
  1. Hyperphosphataemia
  2. Renal failure
  3. Altitude hypoxia
  4. Pregnancy
  5. Cyanotic Congenital Heart disease
  6. Thyrotoxicosis
  7. Some red cell enzyme deficiencies
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20
Q

Conditions associated with reduced 2,3 DPG production

A
  1. Acidosis
  2. Cardiogenic shock
  3. Septicaemic shock
  4. Hypophosphataemia
  5. Hypothyroidism
  6. Transfusion with stored blood
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21
Q

Anemia causes profound *vasoconstriction/vasodilation *

A

Vasodilation

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22
Q

Anaemia causes increased/decreased peripheral resistance

A

Decreased

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23
Q

Anaemia causes narrow/wide pulse pressure

A

Wide

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24
Q

Increased/Decreased blood flow to myocardium

A

Increased

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25
Q

Increased/Decreased Stroke volume

A

Increased

26
Q

In anemia, there’s Increased/Decreased heart rate

A

Increased

27
Q

Increased/Decreased Cardiac output

A

Increased

28
Q

Increased/Decreased whole blood viscosity

A

Decreased

29
Q

Increased/Decreased circulatory time

A

Decreased

30
Q

Signs of failure of cardiovascular adaptive mechanisms

A

Palpitations
Angina of effort
Increased arterial pulsation
Capillary pulsation
Haemic murmurs
Basal crepitations
Cardiomegaly
Peripheral oedema
Ascites

31
Q

Aetiology of anemia

A

Blood loss
Decreased survival or rbcs
Bone marrow failure

32
Q

Anemia of blood loss - Acute losses

A

RTA
Surgery
Massive Antepartum Haemorrhage
Massive Postpartum Haemorrhage
Ruptured Ectopic
DIC

33
Q

Chronic Losses from the GIT can cause anemia. List diseases that cause haematemesis

A

Hiatus hernia
Chronic Duodenal ulcer
Gastric cancer
Salicylate ingestion

34
Q

List diseases that cause Haematochezia

A

Polyposis coli
Diverticulosis
Colonic cancers
Haemorrhoids

35
Q

Hookworms can cause Innocuos GIT loss T/F

A

T

36
Q

List diseases that cause Haematuria

A

Bladder Cancer
Schistomiasis
Chronic Glomerulonephritis
Ureteral stones/erosion
Renal papillary necrosis
Kidney cancers

37
Q

Chronic losses from Female Genital

A

Cervical Erosions/Cervical cancer
Endometriosis
Endometrial cancer
Bleeding endometrial fibroid
Menorrhagia

38
Q

Diseases that canes Haemoptysis

A

Tuberculosis
Heart failure
Wagener Granulomatosis
Pulmonary infarctions
Cancer of the Bronchi
Cancer of the lungs

39
Q

Chronic losses that cause anemia(Purpura)

A

Thrombocytopenia
Vasculopathy
Von Willebrand disease

40
Q

Causes of haemathrosis

A

Coagulant protein deficiencies

41
Q

Causes of Haematoma

A

Coagulant protein deficiencies

42
Q

Examples of chronic losses

A

Haematemesis (Vomiting of Blood)
Haematochezia (Blood in stool)
Innocuous GIT loss
Haematuria
Chronic losses from female genitalia
Haemoptysis (Chronic losses from lungs)
Purpura (chronic losses to the skin)
Haemathrosis (Losses into the joints)
Haematoma (Losses to the soft tissues)

43
Q

Types of Anaemia of decreased red cell survival

A

Intracorpuscular
Extracorpuscular

44
Q

Types of intracorpuscular defects

A

Membrane defects
Cytoplasmic defects

45
Q

Types of membrane defects

A

Acquired
Inherited

46
Q

Examples of Inherited Intracorpuscular Membrane Defects

A

Spherocytosis
Elliptocytosis
Stomatocytosis
Pyropoikilocytosis
Acanthocytosis

47
Q

Example of an Acquired Intracorpuscular Membrane Defect

A

Paroxysmal Nocturnal Haemoglobinuria (PNH)

48
Q

Examples of Cytoplasmic Defects - Enzymopathies

A

Enzymes of Embden-Myerhoff Pathway
Enzymes of Pentose Phosphate Pathway

49
Q

Enzymes of Embden-Myerhoff Pathways

A

Hexose kinase
Pyruvate kinase

50
Q

Enzymes of Pentose Phosphate pathway

A

G6PD
Glutathione reductase
Glutathione peroxidase
Gamma-glutamyl-cysteine synthetase
Glutathione synthase

51
Q

Types of Haemoglobinopathies

A

Qualitative defects
Quantitative defects

52
Q

List the Qualitative Haemoglobinopathies

A

Aggregating haemoglobins - S, C, D and E
Unstable haemoglobins

53
Q

List the Quantitative Haemoglobinopathies

A

Thalassaemias- alpha, beta and beta- delta

54
Q

Other corpuscular defects

A
  1. Low ATP concentration
  2. ATPase deficiency
  3. Erythropoietic porphyria
  4. Increased red cell lecithin
55
Q

Types of extra corpuscular defects

A
  1. Immune Mechanisms
  2. Chemicals/Drugs
  3. Toxins/Poisons
  4. Metals
  5. Waste Metabolic Products
  6. Infections
  7. Intravascular Fragmentations
  8. Heightened Phagocytic activity
56
Q

Types of immune mechanisms

A

Warm reacting Antibodies
Cold reacting antibodies

57
Q

Types of warm reacting antibodies

A

Isoimmune
Autoimmune

58
Q

Causes of anemia due to isoimmune warm reacting antibodies

A

Transfusion
Haemolytic disease of the new born

59
Q

Causes of anaemia due to autoimmune warm reacting antibodies

A

SLE
Idiopathic

60
Q

Causes of decreased red cell survival due to cold reacting antibodies

A

Cold Agglutinin Syndrome
Paroxysmal cold Haemoglobinuria

61
Q

Apart from PNH, Acquired Membrane pathology can also be caused by Zeid’s triad

A

Alcoholic liver disease
Hyperlipidemia
Hemolytic anemias

Haematology (3 decks)

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