Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BRS YEAR 2 > Aneamia > Flashcards

Aneamia Flashcards

1
Q

what is the normal range for bilirubin?

A

below 17 umol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what does high unconjugated bilirubin suggest?

A

prehepatic jaundice e.g. haemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

cause of spherocytes?

A

hereditary spherocytosis
Disruption of vertical linkages in membrane of erythrocyte usually ankyrin and spectrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is reticulocytisis a sign of

A

haemolysis → underdeveloped cells in circulation means RBC turnover is happening too quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the difference between haemolysis and haemolytic anaemia?

A

haemolysis is RBC breakdown, haemolytic anaemia = lifespan reduced to the extent that Hb is low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

treatment options for haemolytic anaemia?

A

folic acid → supports increased requirement for erythropoiesis

splenectomy if severe → increase RBC life span

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

one consequence of haemolysis?

A

Gallstone formation due to increased breakdown of haemoglobin to bilirubin causing obstructive jaundice
Liver can still conjugate bilirubin but it’s not passing from the bile ducts and gallbladder into the duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what does it mean for bilirubin to be conjugated vs unconjugated

A

water soluble, not as attached to albumin

Unconjugated is insoluble in blood and attached to albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does conjugated vs unconjugated bilirubin affect the body and how are they excreted

A

unconjugated toxic to tissues and organs, can’t be excreted in urine,accumulates in prehepatic jaundice

conjugated pretty non-toxic, excreted in urine (dark),accumulates in post hepatic jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is autoimmune haemolytic anaemia?

A

haemolysis mediated by autoantibodies against own RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is autoimmune haemolytic anaemia diagnosed

A

DAT (direct antiglobulin test) checking for autoantibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

AIHA aetiology

A

idiopathic, related to other immune disorders e.g. SLE, underlying lymphoid cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Signs of Haemolysis

A

raised LDH, unconjugated hyperbilirubinaemia, low haptoglobins

Bone marrow responds via reticulocytosis

Defect in rbc means inherited and defect in rbc environment means acquired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  • what are irregularly contracted cells and Heinz bodies a sign of?
A

Oxidant damage to rbc which indicates G6PD deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does G6PD do

A

important in HMP shunt → coupled to glutathione metabolism → protects from oxidant damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

sources of oxidants?

A

generated in the blood stream e.g. during infection

exogenous e.g. fava beans, drugs like naphthalene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is intravascular vs extravascular haemolysis?

A

intravascular = acute damage

extravascular = removal by spleen

18
Q

what does ferritin do?

A

Iron stores in liver

19
Q

Transferrin

A

Allows iron to be transported in blood

20
Q

what does low transferrin indicate?

A

Iron overload

21
Q

signs of iron deficiency anaemia?

A

fatigue, koilonychia, angular stomatitis, glossitis, microcytic anaemia

22
Q

Causes of iron deficiency anaemia

A

bleeding e.g. GI (would see dysphagia, dyspepsia,abd pain)or menstrual, diet, hookworm, malabsorption e.g. coeliac disease or h. pylori gastritis,change in bowel habit (haematemesis,rectal bleeding,melaena),NSAIDS

23
Q

when might increased iron be required?

A

Pregnancy
Infancy

24
Q

what measurement abnormality does RBC hypochromia indicate?

A

Low MCHC

25
Q

treatment of iron deficiency?

A

iron replacement e.g. ferrous sulphate tablets

26
Q

what causes increased iron absorption from the gut and increased release from storage?

A

low hepcidin

27
Q

Normal Hb range

A

133-167

28
Q

does a normal ferritin always exclude iron deficiency?

A

no → can be normal if both iron deficiency and anaemia of chronic disease

29
Q

what is the difference between macrocytic and megaloblastic anaemia?

A

megaloblastic is a type of macrocytic anaemia
Megaloblasts are large with nucleocytoplasmic dissociation

30
Q

what is megaloblastic anaemia commonly caused by?

A

Folate or B12 deficiency

Can occur secondary to agents or mutations that impair dna synthesis eg
Drugs azathioprine cytotoxic chemo
Folate antagonist eg methotrexate
BM cancers eg myelodysplatic syndrome

31
Q

What does b12 and folate do

A

B12: DNA synth, integrity of nervous system

folate: DNA synth, homocysteine metabolism

32
Q

colour status of normocytic, macrocytic and microcytic anaemia RBCs?

A

normocytic and macrocytic = normochromic

microcytic = hypochromic

33
Q

what does microcytosis result from?

A

Reduced synthesis of HB

34
Q

haem and globin issue examples respectively?

A

haem: iron deficiency, anaemia of chronic disease

globin: thalassaemia

35
Q

causes of normocytic anaemia?

A

recent blood loss

bone marrow failure e.g. chemo, leukaemia → RBC production failure

pooling of RBCs in spleen

36
Q

Environmental factors which can damage rbc

A

Environmental factors affected rbc
Non immune-microangiopathic,haemolytic uraemic syndrome,malaria,snake venom,drugs

Immune mediated-autoimmune,allo immune (post blood transfusion)

37
Q

Ghost cells

A

Are cells that are pale due to loss of haemoglobin content
Can be due to Intravascular haemolysis which include conditions such as G6PD deficiency,autoimmune haemolytic anaemia and toxins such as snake venom

38
Q

Haemolytic anaemia inherited vs acquired causes

A

Inherited
Abrnkmak rbc membrane eg Heridetary spherociytosis
Abnormal Hb eg sickle cell anaemia
Defect in glycolytic pathways eg Pyruvate kinase deficiency
Deficiency in G6PD

Acquired
Damage to rbc membrane via AIHA or snake bite
Damage to whole rbc eg MAHA (microangiopathic haemolytic anaemia)
Oxidant exposure damage to rbc and Hb eg dapsone or primaquine

39
Q

Anaemia of chronic disease

A

Hb low,MCV low or normal,ferritin high,,serum iron low,transferrin normal/low

Hepcidin made by liver when iron stores high and also made when inflammation has occurred eg in infection such as TB/HIV,rheumatoid arthritis,malignancy,autoimmune disease

Treatment needs to target underlying cause

40
Q

Why does b12/folate deficiency occur

A

B12:due to diet eg veganism,gastric eg gastrectomy or autoimmune (pernicious anaemia -anti gastric parietal cell and intrinsic factor antibodies),terminal ileum eg chrons disease or ileal resection. Can treat via supplements for diet but other two require hydroxocobalamin injections

Folic acid-diet (poverty/alcholism),malabsorption due to coeliac disease or jejunal resection,increased demand due to pregnancy,lactation or increased cell turnover (Haemolysis). For all give supplements

BRS YEAR 2 (43 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions