Blood Disorders Flashcards
What is anaemia?
A decrease in red blood cells or a subnormal level of haemoglobin.
Who does it effect?
Males = less than 130g/L Females = less than 120g/L
What are the two methods of classification?
Etiologic - the factor that responsible for anaemia
Morphologic - shape and appearance of red cells.
Define normocytic.
Appearance and size of the cell is normal
Define macrocytic and give an example
Cells are larger than normal
E.g. Vitamin B or folic acid deficiency anaemia
Define Microcytic
Cells are smaller than normal
Define hypo-chromic
Reduced haemoglobin content
Define hypo-chromic microcytic and give an example.
Smaller than normal and reduced haemoglobin content e.g iron deficiency anaemia
What is the etiologic classification?
It is the inadequate production of red cells and the excessive loss of red cells.
What is transferrin?
A glycoprotein that transports iron through blood plasma.
How is iron bound and stored in the body?
Iron is bound to the heme or stored bound to ferritin or hemosiderin mononuclear phagocytes and hepatic parenchymal cells.
Describe the factors influencing iron absorption.
- Haem iron absorbed better than non haem iron
- ferrous iron is absorbed better than ferric iron
- Gastric acidity which helps keep the iron in a ferrous state and soluble in the upper gut.
- formation of insoluble complexes with the phytate or phosphate decrease iron absorption.
- iron absorption in increases with low iron stores and increased erythropetic activity e.g bleeding
- there is decreased absorption in iron overload except in hereditary haemochromatosis where it is increased.
What is Apotransferrin?
The iron free form of transferrin
What is iron deficiency anaemia?
It is hypochromic microcytic anaemia
What are the causes of iron deficiency anaemia?
- Inadequate iron intake in diet.
- Inadequate reutilisation or iron present in red cells for to chronic blood loss.
What are the characteristics of a lab profile for iron deficiency anaemia?
- Low serum ferritin and serum iron
- Much higher than normal serum iron binding protein.
- Lower % of iron saturation.
What are the symptoms of iron deficiency anaemia?
Fatigue
Headache
Dizziness
What are the unwanted effects of iron deficiency anaemia?
Acute and chronic blood toxicity
What are the oral treatments for iron deficiency anaemia?
- Ferrous sulphate/Gluconate/Fumarate
- Fe/Fe + folic acid/ Fe + vitamins + minerals
What are the I.V. Treatments for iron deficiency anaemia?
Fe - dextran/sucrose
What is folate deficiency?
It is microcytic anaemia.
What is the importance of folic acid?
It is required for DNA synthesis and cell protection.
Where does the absorption of folic acid occur?
In the small intestine (upper GI)
What are the risk factors of folate deficiency?
- Crohns and coeliac disease - low absorption
- Inadequate intake due to alcoholism, older age and malnutrition.
- Hyper utilisation due to pregnancy/ growth spurs
What are the symptoms of folate deficiency?
Fatigue
Cardiac symptoms
Pale
What are the treatment option for folate deficiency?
Oral folic acid 5mg daily for three weeks, maintain 1xweek
What are the side effects (folate deficiency)
Decreased appetite
Flatulent
Vitamin B12 deficiency
Exacerbation
what is Vit B12 deficiency?
its is macrocytic anaemia. it is the lack of intrinsic factor due to gastric mucosal atrophy
What causes Vit B12 not be absorbed?
atrophy lowers secretion of acid and digestive enzymes
What is the treatment option for Vit B12 deficiency?
Inter-muscular Vit B12 hydroxgcobalamin 1000ug
What are the symptoms?
nausea
weak
dementia
