Blood: 1. Anaemias Flashcards
Sickle cell anaemia
An inherited disorder that causes abnormally shaped haemoglobin, causing red blood cells to be shaped like crescent moons
Complication of sickle cell anaemia
sickle cell crisis - red blood cells obstructing blood vessels to vital organs, causing severe pain. EMERGENCY
Supplementation in sickle cell
Haemolytical anaemia is common in sickle cell disease, therefore increased folate is required in sickle cell anaemia to help make new red blood cells through erythropoesis
Hydroxycarbamide helps to reduce frequency of crises by stimulating haemoglobin production
G6PD defiency
what is it
G6PD defiency characterised as a deficiency of glucose-6-phosphate dehydrogenase (enzyme that helps red blood cells function normally).
Can lead to haemolytic anaemia, after exposure to medicines, infections or foods
Common in Africans, Asians, Southern Europeans, and more common in males
Drugs with a definite risk of causing haemolytical anaemia
- Dapsone and other Sulphones
- Sulphonamides
- Nitrofurantoin
- Quinolones
- Rasburicase
Iron deficiency anaemia symptoms
- tiredness
- pale skin
- shortness of breath
- palpitations
Conditions where iron prophylaxis is required
- Crohn’s disease due to malabsorption of nutrients from gastro-intetsinal tract -PARENTERAL IRON
- Gastrectomy due to malabsoroption of nutrients -
PARNTERAL (as oral will be improperly absorbed) - Menorrhagia - due to heavy loss of blood
- Haemodialysis - due to loss of blood
- Pregnancy - Extra iron required for growing baby
- Low birth weight - more susceptible to nutritional deficiencies
Iron counselling
Iron is best absorped on an empty stomach, though as it can cause gastro-intestinal side effects it is best **taken with food
**
Commonly causes constipation or diarrhoea, causes SEVERE diarrohoea in Irritable bowel syndrome
**Vitamin C ** aids iron absorption, so best taken with a glass of orange juice
Should be continued for 3 months after blood levels return to normal
Compound preparation functions
Consist of Folid acid AND iron, to only be used for pregnant women at high risk of iron and folic acid deficiency
Parenteral iron considerations
How must it be administered, what are the risks
Parenteral iron can cause hypersensitivity reactions even when previous administration has been tolerated
- Test doses NOT recommended
- Must be administered by trained staff, resuscitayions must be immeditaly available. Must be monitored for 30 minutes after each injection.
- Must be avoided in pregnancy (should not be given in 1st trimester, can be given in 2nd or 3rd if no other choice)
- Greater risk of hypersensitivity in allergies: atopic conditions, immune, inflammatory conditions
Megaloblastic anaemia
(vitamin b12 or folic acid deficiency)
Large red blood cells with a decrease in the number of the cells. Can be caused by vitamin B12 deficiency or Folic acid defiiency.
Symptoms:
* Numbness, tingling of hands/feet, muscle weakness, depression
Vitamin B12 deficiency causes
CAUSES
dietary deficiency; treated with oral hydroxocobalamin
Malabsorption: gastrectomy, Crohn’s disease, Perniscious anaemia (lack of GI intrinsic factor)
Vitamin B12 deficiency treatment
- Dietary deficiency; treated with **oral hydroxocobalamin **
- Malabsorption: gastrectomy, Crohn’s disease, Pernicious anaemia (lack of GI intrinsic factor) treated with IM hydroxocobalamin
Folic acid alone given in vitamin B12 defiency causes neuropathy of the spinal cord. Must be given WITH vitamin B12.
Folate deficiency causes
- Poor diet
- Coaeliac disease –> malabsorption
- Pregnancy
- Anti-epileptics and methotrexate
Folate deficiency treatment
Folic acid is taken daily for 4 months.
Folic acid should never be given alone for undiagnoses megaloblastic anaemia or vitamin B12 deficiency - can cause neuropathy of the spinal cord
