Approach to diagnosing anaemia

Question 1

In order, list the top 3 common causes of anaemia in Australia

Answer 1

1. IDA (Iron Deficiency anaemia)
2. Thalasemmia
3. CKD (Chronic kidney disease)

Question 2

Significant findings of anaemia

Answer 2

• dec [Hb], dec [RBC], dec HCT (size)
• <135 g/L (adult male)
• <115 g/lL ( adult female)

Question 3

3 classifications of anaemia

Answer 3

1. Morphological: RBC characteristics (size, colour, shape & lab values - MCV (size), MCH (Hb), MCHC [Hb])
2. Functional: pathophysiological mechanisms
3. Aetiological: the main cause that causes anaemia

Question 4

morphological feature of IDA

Answer 4

microcytic hypochromic cells

Question 5

3 types of defects that cause functional classification of anaemia

Answer 5

1. Proliferation: disorder of erythropoesis
2. Maturation defect: Genetic or nutritional
3. Survival defect: Loss (hemorrhage) or destruction (haemolysis)

Question 6

Aetiology that cause Proliferation defects (functional class.) & the usual morphology of RBC

Answer 6

• Renal disease => Insufficent erythropoetin
• Lymphoma => Bone marrow damage
• Radiation, chemo => Stem cell damage
  • Morph: normocytic, normochromic

Question 7

Types of maturation defects (include morphology & aetiology)

Answer 7

Nuclear defect
- Morph: macrocytic, normo*/hypochromic 
- B12, folate deficiency
Cytoplasmic defect
- Morph: microcytic, hypochromic
- Fe deficiency

Question 8

Describe survival defect & overall morphology

Answer 8

• Haemorrhage (loss): overwhelmed haemostasis
BC trauma or Haemophilia A
• Haemolysis (destruction): intravascular or extravascular
BC of Pyruvate kinase deficiency, Autoimmune haemolyti anaemia
• Morph: normocytic, normochromic

Question 9

Lab investigations of anaemia

Answer 9

1. Full blood count: Hb, RCC, Hct, MCV, MCH, MCHC, RDW
2. Peripheral blood film: shape, size, colour
3. Reticulocyte count: supravital dye w/ New Methylene blue