B7 Haemotology: Anaemias Flashcards

1
Q

Name the six types of anaemia

A
Iron anaemia 
Megaloblastic anaemia 
Haemolytic anaemia 
Aplastic anaemia 
Sickle cell anaemia 
Thalassaemias
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2
Q

Symptoms and signs of anaemia

Why is skin colour not a reliable sign?

A
Shortness of breath 
Weakness 
Lethargy
Tachycardia 
Skin colour determined by blood flow rather than Hb 
Nail bed and conjunctiva may be pale
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3
Q

In iron deficiency anaemia explain how input = output can be altered?

A
Input reduced (poor diet/surgical removal of stomach)
Output increased (menstruation/GI bleeding ulcers)
Demand increased (pregnancy)
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4
Q

In acute bleeding what are the expected changes blood counts

A

DECREASED ; Hb, Haemocrit, WBC, platelets
INCREASING : EPO
Normal iron stores

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5
Q

In chronic bleeding what are the expected changes to blood counts

A

DREASED ; HB, Haemocrit, MVC
INCREASED: Retics, EPO
Zero iron stores

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6
Q

Treatment of iron deficient anaemia

A

1 find and treat underlying cause e.g GI bleed
2 oral iron sulphate
3 prophylaxis in pregnancy
4 transfusion

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7
Q

What is renal anaemia ? How can it be treated?

A

A complication of CRF
Leads to normocytic anaemia
Treat with Fe and EPO injections

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8
Q

What is megaloblastic anaemia?

A

Rarer form of anaemia due to abnormal RBC maturation as a result of defective DNA synthesis

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9
Q

What is macrocytic megaloblastic anaemia ? Causes?

A

Red blood cells are larger than normal due to vit B12 or folate deficiency

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10
Q

Why is B12 important?

A

Essential co factor for purine and pyrimidine synthesis (DNA)

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11
Q

Draw Role of B12 cofactor diagram

A

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12
Q

Why is folate important?

A

essential for thymidylate synthesis (RDS in DNA synth as thymidine is a pyrimidine base

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13
Q

Methorexate case

A

Inhibits dihydrofolate reductase therefore folate regeneration impaired - treat with folic acid

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14
Q

What is pernicious anaemia?

A

Lack of intrinsic factor for absorption of B12 due to auto immune disease

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15
Q

What are haemolytic anaemias?

What is spherocytosis?

A

Increased rate of RBC destruction

Genetic - abnormal reduction in RBC membrane protein (spectrin) makes cells fragile

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16
Q

What is sickle cell anaemia?

A

Genetic, caused by SNP (single nucleotide polymorphism)

Abnormal Hb that forms insoluble crytals at low O2 and may block microcirculation –> Causes haemolytic anaemia

17
Q

What is thalassaemias?

What doe the deletion of both alpha genes lead to?

A

Genetic
Reduced rate of alpha and beta globin units production many variations
Leads to death in uterus as only gamma 4 Hb is produced
One alpha gene deletion reduced RBC volume and haemocrit

18
Q

What is aplastic anaemia?

what can this cause?

A

Insufficient production of RBC, WBCs and platelets
Absence of growth
= decreased resistance to infections, increased bleeding, increased tiredness

19
Q

Treatment of aplastic anaemia

A

Immunosuppressants
Colony stimulating factors (increase WBC count)
Bone marrow transplant with a tissue match

20
Q

What is polycythaemia?

A

RBC count is higher than normal
Increased Hb content and Haemocrit
Increased blood viscosity = poor perfusion

21
Q

Signs and symptoms of polycythaemia

A

Ruddy appearance
Headaches
Blurred vision
Hypertension