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TCD Cases > Anemia > Flashcards

Anemia Flashcards

1
Q

Name the 4 pathological processes involved in anemia of chronic disease

A
  1. Chronic infection
  2. Chronic inflammation
  3. Neoplasia
  4. Chronic kidney disease
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2
Q

Characterise anemia of chronic disease

A

Normocytic and normochromic

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3
Q

Name the protein used to transfer iron in the bloodstream

A

Transferrin

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4
Q

Characterise iron deficiency anemia

A

Microcytic hypochromic

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5
Q

What does normochromic mean

A

Concentration of haemoglobin in an average RBC is normal

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6
Q

What are the 2 subdivisions of macrocytic anemias?

A

Nonmegaloblastic and megaloblastic

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7
Q

Suggest 4 potential causes of non megaloblastic anemia

A
  1. Alcoholism
  2. Liver disease
  3. Hypothyroidism
  4. Myelodisplastic syndromes
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8
Q

What other 2 blood abnormalities often accompany a non megaloblastic macrocytic anemia in cases of myelodisplastic syndrome?

A
  1. Leukocytopenia

2. Thrombocytopenia

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9
Q

Suggest 5 medications that can cause a macrocytic anemia

A
  1. Drugs that affect DNA synthesis
  2. Trimethoprim
  3. Phenytoin, sodium valproate
  4. Metformin
  5. Antivirals e.g. Valacyclovir
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10
Q

Give 3 examples of drugs that affect DNA synthesis

A
  1. Azathioprine
  2. Cyclophosphamide
  3. Sulphasalazine
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11
Q

What is the most common cause of megaloblastic anemia?

A

Pernicious anemia

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12
Q

What are the 3 potential causes of vitamin B12 deficiency?

A
  1. Malabsorption (pernicious anemia or coeliac disease)
  2. Insufficient dietary intake
  3. HIV
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13
Q

Where in the digestive system is folate absorbed?

A

Passive diffusion in the jejunum

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14
Q

What is the function of vitamin B12?

A

Coenzyme that produces methionine from homocysteine. This then converts folic acid into its active form.

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15
Q

What are the 3 textbook physical signs of anemia?

A
  1. Pallor
  2. Bounding Pulse
  3. Systolic flow murmur
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16
Q

What are the ‘normal’ ranges for Hb in males and females respectively?

A

Male - 121-166 g/L

Female - 121-151 g/L

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17
Q

What is the ‘normal’ MCV range?

A

77-94 fl

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18
Q

What is the normal MCH range?

A

27-34 pg

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19
Q

What is a normal white cell count?

A

4.5-13.0 *10^9/L

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20
Q

What is a normal neutrophil count?

A

1.5-6.0*10^9/L

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21
Q

What is a normal lymphocyte count?

A

1.5-4.5*10^9/L

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22
Q

What is a normal platelet count?

A

150-400*10^9/L

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23
Q

What is a normal absolute reticulocyte count?

A

40-105*10^9/L

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24
Q

Women presenting with iron deficiency anemia as a result of menorrhagia should be routinely screened for what blood abnormality?

A

Von Willebrand’s disease

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25
Q

Name a frequent complication associated with hereditary spherocytosis

A

Gallstones

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26
Q

What is the main cause of death for patients with beta thalassaemia major?

A

Cardiac iron overload

27
Q

Name 3 side effects associated with EPO administration

A
  1. Increased BP
  2. Pure red cell aplasia
  3. Thrombotic tendency
28
Q

Name 2 conditions that pigmented gallstones can be associated with

A
  1. Haemolytic anemia

2. Liver cirrhosis

29
Q

What are the 3 main causes of a normocytic, normochormic anemia?

A
  1. Acute blood loss
  2. Anemia of chronic disease
  3. Anemia of renal failure (deficiency in EPO)
30
Q

What is the pathophysiology of RBC production associated with sideroblastic anemia?

A

Slowing of porphyrin ring synthesis

31
Q

What is the pathophysiology of RBC production associated with thalassaemia?

A

Reduction in the speed/quantity of globulin synthesis

32
Q

Name the 3 haematinic deficiencies that may lead to anemia

A
  1. Iron
  2. B12
  3. Folate
33
Q

What type of anemia is associated with thalassaemia?

A

Hypochromic, microcytic anemia

34
Q

What is beta thalassaemia minor and how can it be diagnosed?

A

Effectively a carrier of beta thalassaemia as these individuals only possess one abnormal beta globing gene. Can be diagnosed by having a raised HbA2.

35
Q

Outline the 4 types of alpha thalassaemia with reference to the number of deleted genes.

A

I gene deleted - Clinically silent
2 genes deleted - alpha thalassaemia trait
3 genes deleted - Haemoglobin H disease
4 genes deleted - Bart’s Hydrops Fetalis

36
Q

Name 3 medical conditions in which patients often suffer from malabsorption of vitamin B12

A
  1. Crohn’s
  2. Coeliac
  3. Cystic fibrosis
37
Q

How much elemental iron should be given to patients with iron deficiency anemia each day?

A

100-200 mg

38
Q

What drug category can reduce the absorption of iron tablets if administered at the same time?

A

Tetracyclines

39
Q

What is the name of the vitamin B12 injection given to patients?

A

Hydroxocobalamin injection

40
Q

Define a haemolytic anemia

A

Anemia due to the destruction of red blood cells

41
Q

Name 2 congenital causes of haemolytic anemia that affect the cell membrane of RBCs

A
  1. Hereditary eliptocytosis

2. Hereditary spherocytosis

42
Q

Name 2 congenital causes of haemolytic anemia that are as a result of RBC enzyme deficiencies

A
  1. G6PD

2. Pyruvate kinase

43
Q

Name 2 congenital causes of haemolytic anemia that are brought about by RBC haemoglobin disorders

A
  1. Thalassaemia

2. Sickle cell disease

44
Q

Suggest 4 potential causes of acquired haemolytic anaemia

A
  1. Autoimmune haemolysis
  2. Microangiopathic haemolytic anemia
  3. Drugs
  4. Wilson’s disease
45
Q

Outline the 2 components of primary stroke prevention in patients with sickle cell disease

A
  1. Detection using transcranial Doppler

2. Start regular transfusions

46
Q

What is IRIDA?

A

Iron refractory iron deficiency anemia - Autosomal recessive condition that will not respond to oral iron supplimentation

47
Q

IRIDA is caused by mutations in which gene?

A

TMPRSS6

48
Q

What are the 4 main causes of a hypochromic microcytic anemia?

A
  1. Iron deficiency
  2. Anemia of chronic disease
  3. Sideroblastic anemia
  4. Thalassaemia
49
Q

Hyper-segmented neutrophils are seen on the blood film of patients with which type of anaemia

A

Megaloblastic anemias

50
Q

What is the inheritance pattern of hereditary spherocytosis?

A

Autosomal Dominant

51
Q

What is the characteristic feature of G6PD deficiency?

A

Episodic intravascular haemolysis

52
Q

What is the inheritance pattern of G6PD deficiency?

A

X-linked

53
Q

What is the inheritance pattern of pyruvate kinase deficiency?

A

Autosomal recessive

54
Q

Recall the autoantibodies associated with warm and cold AIHA respectively

A

Warm - IgG

Cold - IgM

55
Q

Suggest 4 potential causes of warm autoimmune haemolytic anemia

A
  1. SLE
  2. Lymphoma
  3. Chronic lymphocytic leukaemia
  4. Drugs e.g. methyldopa
56
Q

What is the main pathophysiological difference between warm and cold AIHA?

A

The temperature at which maximal haemolysis occurs - hence warm or cold. In addition in warm AIHA, haemolysis occurs extravascularly e.g. the spleen where as in cold AIHA haemolysis coccus intravasculalry.

57
Q

Suggest 3 potential causes of cold AIHA

A
  1. Lymphoma
  2. Mycoplasma infection
  3. EBV infection
58
Q

Outline 3 types of microangiopathic haemolysis

A
  1. Thrombotic thrombocytopenic purpura
  2. Haemolytic uremic syndrome
  3. DIC
59
Q

What is Coomb’s test?

A

Antiglobulin test used to test the patients serum for antibodies to red blood cells

60
Q

Name the 2 types of anti globulin tests performed as well as their indications

A
  1. Indirect antiglobulin test - used to crosshatch for transfusion suitability
  2. Direct antiglobulin test - Detection of antibodies to the patients own serum which can cause an autoimmune haemolytic anemia
61
Q

What is the triad of symptoms associated with Plummer-Vinson syndrome?

A
  1. Oesophageal webs
  2. Iron deficiency anemia
  3. Dysphagia
62
Q

Define sideroblastic anemia

A

Abnormality of Haem production in the porphyrin pathway

63
Q

Give 2 potential causes of acquired sideroblastic anemia

A
  1. Lead poisoning

2. Isoniazid

TCD Cases (25 decks)

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