Anemia

Question 1

Hb Reference interval

Answer 1

male = 130-175 g/L
female = 120-155 g/L

Question 2

Normal RBC - appearance, development

Answer 2

biconcave disc - 7um diameter
centrla pallor
contain Hb
made in bone marrow (EPO is needed)
young cells called erythroblasts which grow surrounded by macrophages that provide iron to build heme groups.

Question 3

normal Hb structure

Answer 3

4a globin chains
2b globin chains
central heme

Question 4

Result of aneamia

Answer 4

decreased RBC or RBC Hb = decreased O2 carrying capacity = tissue hypoxia

Question 5

anemia - Clinical fts

Answer 5

signs = pallor
symptoms = fatigue, SOB, palpitations
if vascular disease too = angina, claudication

Question 6

Anemia - how it occurs (3)

Answer 6

1. reduced RBC or Hb production
   - folate deficiency, thalassaemia, lack of EPO, bone marrow disease
2. increased RBC destruction (heamolysis)-
   inherited or acquired
3. blood loss
   - acute trauma or surgery

Question 7

3 cell size classification

Answer 7

1. microcytic
2. normocytic
3. macrocytic

Question 8

Microcytic anaemia causes (3)

Answer 8

1. iron deficiency - need iron to make heme to make Hb
2. Thalassimia - decrease globin production needed for Hb production
3. inflammation - iron sequestered in macrophages by hepcidin.

Question 9

microcytic anaemia - Iron deficiency causes (3)

Answer 9

1. excessive loss: GI, excessive menstruation, trauma/surgery
2. reduced absorption: coeliac, bowel disease, poor diet + veggo
3. increased demand - pregnancy or child growth

Question 10

microcytic anaemia - thalassaemia

Answer 10

gene mutation leading to lack of globin proteins. mutation is a decrease in globin production but ones produced are normal.
alpha or beta thalassaemia.
large severity range.
ALSO excessive globin chains accumulate and damage RBC/precursors.

Question 11

microcytic - inflammation anaemia

Answer 11

of chronic disesae where the is a functional iron deficiency.
liver produces HEPCIDIN to starve bacteria of iron. Hepcidin closes iron gates of macrophages - traps iron in and of gut cells = decreased iron absorption.
RBC look iron deficient but iron stores are normal.
associated w: chronic infection, malignancy, inflammation

Question 12

Macrocytic anaemia - main cause and others

Answer 12

folate deficiency is main cause folate is needed for DNA synthesis in RBC
deficiency = delayed and abnormal RBC nucleus maturation, defective cells die in marrow, surviving ones become megaloblasts (big)
others: liver disease, alcohol, bone marrow diseases, cytotoxic drugs

Question 13

normocytic anemia - causes

Answer 13

chronic renal failure = low EPO, Hb down to 50-80g/L, toxic products decrease RBC life span.
acute blood loss
bone marrow disease
heamolysis

Question 14

haemolytic anaemia

Answer 14

decreased RBC so body increases reticulocyte count as response. (younger bigger RBC)
from either:
- acquired destruction of RBC from macrophages engulfing them or part of their memnbrane.
- inherited abnormal RBC (cell membrane abnormalities, hemoglobinopathies, enzymopathies)

Question 15

malignant anemia

Answer 15

ion deficiency from havign a gastric, uterine, urinary tract cancerous growth, bleeding bowels,.
marrow infiltration from metastasis.