blood Flashcards
what may presence of Schistocytes indicate?
- HUS
- DIC
- TTP
- haemolytic anaemia
causes of MICROCYTIC anaemia? (TAILS)
- Thalassaemia
- Anaemia of chronic disease
- Iron deficiency anaemia
- Lead poisoning
- Sideroblastic anaemia
iron deficiency anaemia blood film findings?
microcytic hypochromic anaemia
low ferritin
causes of NORMOCYTIC anaemia? (5)
- Acute blood loss
- Aplastic anaemia
- Haemolytic anaemia
- Hypothyroidism
2 divisions of macrocytic anaemia
megaloblastic & normoblastic
what is megaloblastic anaemia
impaired DNA synthesis caused by a vitamin deficiency. this results in the cell continuously growing instead of dividing
cause of megaloblastic anaemia (2)
- vitamin B12 def
- folate def
5 causes of MACROCYTIC anaemia
- alcohol
- hypothyroidism
- reticulocytosis
- liver disease
- azathiprine
symptoms of anaemia
- tiredness
- sob
- headache
- dizzy
- palpitations
2 specific symptoms of Iron deficiency anaemia
- pica
- hair loss
what is pica & what its related to
specific symptom of iron deficiency anaemia
dietary cravings for specific things e.g. dirt
sign in haemolytic anaemia
jaundice
bone deformities occur in which blood disorder
thalassaemia
4 specific examination signs in Fe def anaemia
- atrophic glossitis
- angular stomatitis
- brittle hair & nails
- Koilonychia
6 initial blood tests for invx anaemia
- Haemoglobin
- MCV - mean cell volume
- B12
- Folate
- Ferritin
- Blood film
4 causes of iron deficiency anaemia
- increased requirements e.g. pregnancy
- poor absorption
- blood loss (slow)
- poor diet
where is iron absorbed
- duodenum
- jejunum
group of medications that can affect Iron levels due to affecting acidity of stomach
Protein pump inhibitors
medical conditions affecting Fe absorption
Chrons disease
Coeliac disease
most common causes of GI tract bleeding (2)
- gastritis
- oesophagitis
TIBC & transferrin levels in Iron deficiency anaemia
both are high
expected rise of haemoglobin with iron supplementation
10 grams/litre per week
how is slow correction of iron deficiency anaemia achieved?
Ferrous sulfate 200 mg TDS
SE iron tabs
- black stools
- constipated
Vitamin B12 found in which foods?
meat, fish, dairy products
what is Vit B12 bound to in the stomach
intrinsic factor
4 causes of B12 deficiency
- pernicious anaemia
- dietary e.g. vegans
- ileal resection
- chrons disease
pathophysiology of Pernicious anaemia
Autoimmune condition where antibodies form against parietal cells or intrinsic factor
what cells produce intrinsic factor
parietal cells of stomach
neurological symptoms of low Vit B12
- peripheral neuropathy
- loss of vibration sense & proprioception
- visual changes
- mood/cognitive changes
auto antibodies in pernicious anaemia
1) Intrinsic factor antibody
2) Gastric parietal cell antibody
dietary replacement for Vit B12 deficiency?
cyanocobalamin
Treatment of Vit B12 deficiency anaemia due to malabsorption
1mg of intramuscular hydroxycobalamin 3 times weekly for 2 weeks
treatment of folate deficiency anaemia?
treat B12 deficiency first
then folate
treating B12 deficiency with folic acid can lead to what?
subacute combined degeneration of spinal cord
inheritance of beta & alpha thalassaemia
autosomal recessive
patho of thalassaemia?
The red blood cells are more fragile, therefore break down more easily. The bone marrow expands to produce extra blood cells –> susceptibility to fractures & pronounced forehead and malar eminences
signs & symptoms of thalassaemia?
- pronounced forehead and malar eminences
- poor growth & development
- splenomegaly
- jaundice
- pallor
- gall stones
- fatigue
- MICROCYTIC ANAEMIA
thalassaemia - type of anaemia?
microcytic anaemia (low MCV)
how is thalassaemia diagnosed? (3)
- FBC: microcytic anaemia
- Haemoglobin electrophoresis
- DNA testing
in Thalassaemia, what occurs as a result of frequent blood transfusions?
IRON overload
symptoms of iron overload (7)
Fatigue Liver cirrhosis Infertility and impotence Heart failure Arthritis Diabetes Osteoporosis and joint pain
management of iron overload
iron chelators
eg. of iron chelator & side effects?
Deferoxamine
- blurred vision
- ringing in ears
- dizziness
