Case 11 - Anaemia - Progress Test Flashcards
What are the causes of microcytic anaemia?
Iron deficiency anaemia Thalassaemia Congenital sideroblastic anaemia Anaemia of chronic disease (more commonly normocytic however) Lead poisoning
What are the causes of normocytic anaemia?
Anaemia of chronic disease Chronic kidney disease Aplastic anaemia Haemolytic anaemia Acute blood loss
What are the causes of a macrocytic anaemia?
Megaloblastic causes:
- vitamin B12 deficiency
- Folate deficiency
Normoblastic causes:
- alcohol
- liver disease
- hypothyroidism
- pregnancy
- reticulocytosis
- myelodysplasia
- drugs: cytotoxins
What are the causes of iron deficiency anaemia?
Excessive blood loss
Inadequate dietary intake
Poor intestinal absorption
Increased iron requirements
What can cause a serum ferritin to be raised despite iron deficiency anaemia?
Inflammation
How long should you take iron tablets for after a diagnosis of iron deficiency anaemia?
3 months
What are the causes of B12 deficiency?
Pernicious anaemia
Atrophic gastritis (eg. secondary to H.pylori infection)
Gastrectomy
Malnutrition (eg. alcoholism)
What is the pathophysiology of pernicious anaemia?
Antibodies to intrinsic factor +/- gastric parietal cells
What conditions are associated with pernicious anaemia?
Thyroid disease Type 1 diabetes Addison's Rheumatoid Vitiligo
What would be seen on a blood film in pernicious anaemia?
Hypersegmented polymorphs
What are examples of hereditary haemolytic anaemias?
Membrane defects:
- Hereditary spherocytosis
- Elliptocytosis
Metabolism defects:
- G6PD deficiency
Haemoglobin defects:
- Sickle cell
- Thalassaemia
What are examples of immune causes of acquired haemolytic anaemia?
Ward / cold type antibody
Transfusion reaction
Haemolytic disease newborn
Drugs: methyldopa, penicillin
What are examples of non-mime causes of acquired haemolytic anaemia?
Microangiopathic haemolytic anaemia (MAHA):
- TTP / HUS, DIC, malignancy, pre-eclampsia
Prosthetic cardiac valves
Paroxysmal nocturnal haemoglobinuria
Infections: malaria
Drugs: dapsone
What would investigations in sideroblastic anaemia show?
hypochromic microcytic anaemia
(more so in congenital)
bone marrow:
sideroblasts and increased iron stores
