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Year 2: HAEM > Anemia > Flashcards

Anemia Flashcards

1
Q

what are the appropriate haemoglobin levels for males and females

A

females:110-147 g/l
males:131-166

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2
Q

what is MCV and its classes

A

mean cell (corpuscular) volume (cell size)
-macrocytis - cells larger than norm
-microcytic- cells smaller than norm
-normocytic- cells within norm range

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3
Q

what are the microcytic anemias

A

iron and thallessemia

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4
Q

what are the macrocytic anemias

A
  • folate defic, b12 defic (both magoblastic)
  • haemoloysis
  • bone marrrow disorders
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5
Q

what are the normolytic anemias

A
  • chronic disease
  • renal disease (EPO)
  • acute bleading
  • mixed picture( mix of big and small cells)
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6
Q

what are some characteristics of b12 deficiency (histology)

A

-oval macrocytes
-hypersegmenteg neutrophils (many lobes)

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7
Q

how do you treat b12 anemia

A

b12 injections
Diet

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8
Q

What is the pathology of B12 deficiency

A

low b12
low intrinsic factor (prevents b12 absorbing)

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9
Q

what much iron is cosumed in araaege diet and how much is absorbed

A
  • 15mg
  • 1mg
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10
Q

where is haemoglobin absorbed

A

duodenum and the upper jejunum.

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11
Q

why is pregnancy important with iron

A

body stores appros 4g of iron, baby takes between 500-1000mg of the iron, if mother is borderline before hand, pregnancy could be cussing the anemia caused by iron deficiency (microcytic). Will need supplemental iron

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12
Q

why would celiac disease be important in iron anemia

A

iron is absorbed in dedenum and jejenum, celiac affects the jejenum

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13
Q

how to treat iron anemia (if not caused bu GI malignancy)

A

-200mg iron supplement oral (ferrous sulphate)
-HB shuld inc 20g each 3-4 weeks
-contrinue 3 months after normal values

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14
Q

what are the transferrin value for males and females

A

F:15-45%
M:15-50%

Treanferrrin synthesis inc in iron deficiency. Low

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15
Q

How many mg of folate does a non pregnant person need per day

A

0.1-0.2 mg -needed for DNA

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16
Q

where is Folate absorbed

A

Proximal jejenum

17
Q

what causes folate deficiency

A
  • diet
  • pregnancy
  • crohns
  • coeliac
18
Q

how to treat folate deficiency

A

Supplement
-check B12 first before supplement

19
Q

where is b12 absorbed

A
  • absorbed in terminal illeum
  • must be bound to IF (produce be gatric parietal cells)
20
Q

how long do b12 stores last for

21
Q

what is B12 required for

A

Fatty acid synth and DNA synth

22
Q

what are presenting symptoms of B12 defic

A

neurological symptoms (parasthesia)

23
Q

describe immunology of pernicious anemia (b12)

A

-autoimmunedisctuctin of gastric parietal cells that produce IF

24
Q

investigations for haemolytic anemia

A
  • blood film showing
    -spherocytes
    -polychromasia
    -bilirubin + uncoj
  • Direct antiglobulin test/ Cooms test
25
Q

what are presenting symptoms of haemolytic anemia

A

-normal general anemia symptoms
-jaundices
-gallstones
-leg ulcers

26
Q

Aetiology haemolotic anemia

A
  • inherited
    -RBC membrane deffet (spherocytes)
  • Acquired
    -autoimmune
27
Q

What is sideroblastic aneamia?

A
  • Defective Hb synthesis within mitochondria
  • microcytic
  • Often X inherited ALA synthetase deficiency
  • High Fe but not used in Hb synthesis, trapped in mitochondria!
28
Q

what tests are for sideroblastic anaemia

A
  • FBC + Blood film= Microcytic, low mcv, RINGED SIDEROBLASTS
  • Iron studies - High Serum Fe, HighFerritin, High Transferrin Saturation, Low Total Iron Binding Capacity (TIBC).
  • Marrow biopsy - Increased iron deposition and ringed sideroblasts.
29
Q

how is sideroblastic anermia treated

A

chelation therapy
blood transfusions
avoiding triggers- alchohol

30
Q

Describe G6PD Deficiency

A
  • deficiency of the G6PD Enzyme which leads to anaemia through h**aemolysis.
  • x linked males of Mediterranean, African and Middle Eastern descent **and in patients from countries where malaria is prevalent as it is protective against the infection.
31
Q

whate are the signs and symptoms of G6PD deficiency

A
  • signs = normal anemia= breathlessness,palpitations, fatigue. dsypsnoe
  • symptoms = jaundice, palloe, splenogolamy, dark urine, gall stones
32
Q

how is G6PD Deficiency diagnosed

A

**FBC + blood film **

  • normocytic
  • normochromatic
  • low rbc
  • high reticulocytes
  • heinz bodies + Bitez cells

G6PD Enzyme Assay – Low G6PD

33
Q

how to treat G6PD deficiency

A
  • Avoid Precipitating Factors
  • Blood Transfusions during G6PD attack (rapid anaemia + jaundice
34
Q

what are the signs of iron aneamia

A
  • spoon nails (Koilonychia)
  • Angular stomatitis
  • Atrophic glossitis
  • Brittle hair and nails
  • Subconjunctival pallor
35
Q

what are the signs of beta thallassemia

A
  • Jaundice
  • Pallor
  • Hepatosplenomegaly
  • Chipmunk face:enlarged forehead and cheekbones
  • Failure to thrive
  • Bone deformities

Year 2: HAEM (9 decks)

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