Anaemias (other)

Question 1

Sickle cell disease

Answer 1

Structural abnormality of hb resulting in deformed, less flexible red blood cells.
- Folic acid (makes new red blood cells)

Question 2

Sickle cell crises

Answer 2

Small blood vessels get blocked and blood can’t reach certain organs, leading to intense pain.

Question 3

Sickle cell crises - management

Answer 3

Hospitalisation
Fluid replacement
Analgesia
Treatment of any concurrent infection

Question 4

Sickle cell crises - prevention

Answer 4

Hydroxycarabmide
- Prevent acute chest syndrome
- Reduce the frequency of painful crises
- Reduce transfusion requirements
- May take months for benefits to appear

Crizanlizumab
- Option for preventing recurrent sickle cell crises

Question 5

G6PD deficiency

Answer 5

Inborn (genetic) error in carbohydrate metabolism.
More common in males
Common people from:
- Africa
- Asia
- Mediterranean region
- Middle East

Question 6

G6PD deficiency - info

Answer 6

Predisposes to haemolytic anaemia (spontaneous destruction of red blood cells)
Occurs in response to certain drugs, food or infection.

Question 7

G6PD deficiency - drugs with definite risk

Answer 7

• Dapsone and other sulfones
• Fluoroquinolones
• Nitrofurantoin
• Primaquine
• Rasburicase
• Sulfonamides (including co-trimoxazole)

Question 8

G6PD deficiency - food

Answer 8

Broad beans

Question 9

Aplastic anaemia

Answer 9

• IV horse antithymocyte globulin + ciclosporin (immunosuppressive treatment for aplastic anaemia)
• Prednisolone used to reduce side effects of treatment with antithymocyte globulin

Question 10

Renal anaemia

Answer 10

• Treament = epoetins (recombinant human erythropoietins)
• Epoetin beta = licensed for the prevention of anaemia in preterm neonates of low birth-weight.
• Darbepoetin alfa = longer half-life and can be administered less frequently than epoetin.