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4th yr- CMS- Medicine > ANAEMIAS AND BLOOD TRANSFUSIONS > Flashcards

ANAEMIAS AND BLOOD TRANSFUSIONS Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

Where is bone marrow found

A

It occupies the medullary cavity of long bones and trabeculae spongy bone

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2
Q

What is bone marrow composed of

A

Red and yellow marrow

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3
Q

What is red marrow

A

Flat bones and ends of long bones that are responsible for making blood cells

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4
Q

What is yellow marrow

A

Middle of flat bones mainly made up of fat cells

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5
Q

Describe normal red cells

A
  1. Biconcave disks

2. Not nucleated

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6
Q

What do normal red cells do

A

They transport oxygen via haemoglobin

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7
Q

Where are normal red cells made

A

They are produced in the marrow under the control of the hormone erythropoietin

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8
Q

Where is erythropoietin made

A

Made in the kidneys in repose to tissue hypoxia

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9
Q

What is anaemia defined as

A

A reduction in the haemoglobin concentration of the blood

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10
Q

What is the normal range of haemoglobin

A

135-180 g/l for males

115-155 g/l for females

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11
Q

What is haemoglobin made up of

A

A module of “haem” (iron) and globin (a protein)

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12
Q

Before treating anaemia what must we do

A

Determine the cause

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13
Q

What can anaemia be caused by

A
  1. Blood loss
  2. vitamin or mineral Deficiency
  3. Impaired bone marrow function
  4. Haemolysis
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14
Q

Name some common vitamin deficiency’s that can lead to anaemia

A
  1. Vit b12
  2. Iron
  3. Folate
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15
Q

What can impaire bone marrow function

A
  1. Chemotherapy
  2. aplastic anaemia
  3. bone marrow infiltration with malignant cells
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16
Q

How do we investigate the underlying cause of anaemia

A
  1. Full blood count (FBC)

2. Blood films

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17
Q

What do blood film tell us

A

Gives the Hb concentration and red cell parameters such as Mean Corpuscular Volume) (MVC)and mean cell Hb

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18
Q

List the different types of anaemia

A
  1. Hypo-chromic microcytic anaemia
  2. Microcytic anaemia
  3. Normochromic normocytic anaemia
  4. Thalassemia
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19
Q

What is hypochromic microcytic anaemia

A

Pale small red blood cells

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20
Q

What can Hypo-chromic microcytic anaemia be caused by

A
  1. Iron deficiency

2. thalassaemia

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21
Q

How much iron does the normal adult body contain

A

3-5 grams

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22
Q

How many grams of iron do adult males and females need

A

1mg/day for men

2mg/day for women

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23
Q

When might women need to increase their iron content

A

When they are pregnant they’ll need 3-4mg/day

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24
Q

Where in out diet can we get iron from

A
  1. broccoli,
  2. beans/peas,
  3. potatoes with skins,
  4. spinach,
  5. iron fortified cereals, raisins,
  6. watermelon,
  7. dried apricots,
  8. meat,
  9. egg yolk,
  10. sea food
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25
Q

What can iron deficiency be caused by

A
  1. Blood loss
  2. Pregnancy
  3. Malabsorption
  4. Dietary
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26
Q

What can blood loss be caused by

A
  1. Peptic ulcers
  2. GI cancers
  3. menorrhagia,
  4. hookworm
27
Q

List some clinical features of iron deficiency

A
  1. Fatigue, poor concentration
  2. Breathlessness on excretion
  3. Pallor
  4. Glossitis and angular stomatitis
  5. Koilonychia (concave nails)
28
Q

What is the clinical presentation of iron deficiency dependant on

A

Severity and speed

29
Q

How can we diagnosis iron deficiency

A
  1. Full blood count
  2. Blood film
  3. Plasma ferritin
  4. Bone marrow iron stores
30
Q

What will the FBC of a patient with Hypo-chromic microcytic anaemia look like

A

Anaemia with low mean corpuscular volume and mean cell Hb

31
Q

What will the blood film of a patient with Hypo-chromic microcytic anaemia look like

A

Small pale red cells that are hypochromic/Microcytic

32
Q

What will the plasma ferritin of a patient with Hypo-chromic microcytic anaemia look like

A

Reduced

33
Q

What is the normal plasma ferritin level

A

12-250 MCH/L

34
Q

How do we treat iron deficiency anaemia

A
  1. Iron replacement with oral ferrous sulphate tablets
  2. IV iron if intolerant to oral iron
  3. Blood transfusion
35
Q

What is macrocytic anaemia

A

Vitamin b12 or folate deficiency characterised by megaloblastic anaemia

36
Q

Why is folate important

A

Needed for the synthesis of purine and pyramidine bases needed for DNA

37
Q

Why is B12 important

A

Essential fro cell folate utilisation

38
Q

What can happen if folate or B12 is deficient

A

staves DNA of bases and affects all rapidly dividing cells especially blood cells in marrow §

39
Q

Where can we find B12 in our diet

A

Animal food sources

40
Q

How much Vitamin B12 do we need

A

1-2mcg daily

41
Q

How much vitamin B12 does our body store

A

1mg (enough for 5 years)

42
Q

What can B12 related anaemias include

A
  1. Pernicious anaemia
  2. Disease/resection of the terminal ileum
  3. Dietary
43
Q

Where is folate found

A

Green leafy vegetables and fruit

44
Q

How much folate do we need daily

A

150mcg daily

45
Q

How much folate does our body store

A

100mg

46
Q

What can folate related anaemias be caused by

A
  1. Dietary deficiency
  2. Malabsorption
  3. Increased demands
47
Q

List some clinical features of Microcytic anaemia

A
  1. Fatigue
  2. Weakness
  3. Breathlessness on Exertion
  4. Glossitis
  5. Neuropathies
  6. Aphthous stomatitis
  7. oral dysaesthesias
48
Q

How do we treat Microcytic anaemia

A

supplements orally or as IM injections

49
Q

What can macrocytic anaemia be caused by

A
  1. Vitamin b12 or folate deficiency
  2. myelodysplasia,
  3. haemolysis,
    4, drug and alcohol, pregnancy
  4. hypothyroidism
50
Q

What does normochromic mean

A

Normal coloured

51
Q

What does normocytic mean

A

Normal size

52
Q

What is normochromic normocytic anaemia caused by

A

Chronic disease

53
Q

What is thalassemia

A

A group of inherited conditions affecting haemoglobin characterised by the reduction or absent production of Hb

54
Q

what can a reduction or absence of the production of Hb result in

A

Inability to carry sufficient oxygen in the blood

55
Q

List some of the symptoms of thalassemia

A
  1. Shortness of breath
  2. Fatigue
  3. Fainting attacks
56
Q

Name the 2 variants of thalassemia

A
  1. Trait thalassaemia = asymptomatic

2. Major thalassaemia = severe symptomatic disease

57
Q

How many blood groups are there

A

more than 300

58
Q

What systems do we use in to check blood groups

A
  1. ABO system

2. Rhesus system

59
Q

What is the ABO blood system good fro

A

Important to match donation and patient

60
Q

Name the most common blood group

A

O

61
Q

Name the different blood groups from most common to rarest

A

0
A
B
AB

62
Q

What is fatal haemolytic transfusion reactions caused by

A

Human error

63
Q

How common is fatal haemolytic transfusion reactions

A

1 in 600,000 to 1 in 1,000,000

4th yr- CMS- Medicine (14 decks)

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