causes of anaemia/thrombocytopenia

Question 1

what are some examples of causes of anaemia

Answer 1

blood loss, deficiencies (B12, iron, folate), chronic disease, haemolysis (alcohol, drugs, toxins)

Question 2

what are the names and causes of the classification of MCV (mean cell volume) in RBC’s

Answer 2

normocyte

microcyte (iron deficiency or thalassaemia)

rough macrocyte (liver disease, alcohol, hypothyroidism)

oval macrocyte (magaloblastic anaemia)

Question 3

what would iron deficiency do to the RBC

Answer 3

microcytic anaemia

Question 4

what is the most common cause of anaemia

Answer 4

iron deficiency = microcytic anaemia

Question 5

what is the 3 stage process to treatment of iron deficicency

Answer 5

first establish level - FBC, MCV blood film

establish cause

iron therapy - oral, IM, IV

Question 6

what are the common causes of iron deficiency in child, young women and older people

Answer 6

children - diet, growth, malabsorption

young women - mentrual loss or pregnancy

older - bleeding or GI problem

Question 7

what does an older man with iron deificincy at risk of

Answer 7

bowel cancer

Question 8

describe magloblastic anaemia and the cause

Answer 8

macrocytic anaemia caused by impaired DNA synthesis

RBC bigger, MCV high, lobed nuclei of nucleated blood cells

Question 9

describe magloblastic anaemia

Answer 9

macrocytic anaemia caused by impaired DNA synthesis

RBC bigger, MCV high, lobed nuclei of nucleated blood cells

Question 10

what are specific causes of megaloblastic anaemia (macrocytic anaemia)

Answer 10

most common - B12/folate deficiency (folate required for DNA synthesis and B12 essential for cell folate generation)

alcohol and drugs

Question 11

what is the treatment for megaloblastic anaemia

Answer 11

give B12 and folate until B12 deficiency is ruled out

Question 12

where do we get vit B12 from

Answer 12

animal sources

Question 13

describe the absorption of vit B12

Answer 13

easy - absorbed by binding to intrinsic factor made by parietal cells in the terminal ileum

Question 14

what are some examples of reasons for vit B12 deficiency

Answer 14

nutritional - mainly vegans
gastric - antibodies against intrinsic factor or parietal cells, atrophic gastritis
small bone issues (crohns)
SACDC

Question 15

what is SACDC

Answer 15

sub acute combined degradation of get cord

severe b12 deficiency - peripheral neuropathy, numbness and weak ness

Question 16

where do we get folic acid from

Answer 16

green veg, beans, nuts

Question 17

what causes folic acid deficiency

Answer 17

malnutrition, malabsorption, pregnancy

drugs/alcohol/UTI

Question 18

what is haemolysis

Answer 18

shortened RBC life ie less than 120 days - problems with cell internal machinery, cell membrane or external factors

Question 19

what are the 3 causes of haemolysis

Answer 19

intracellular - enzyme defect (G6DP def) or sickle cell

membranous - hereditary spherocytosis (most common)

extracellular - antibodies, dirges, toxins

Question 20

what investigative clues can be done for haemolysis

Answer 20

anaemia, blood film (look for spherocytes)
raised bilirubin
low haptoglobin
urinary haemosiderin

Question 21

what is the causes and pathogenesis of normcytic anaemia

Answer 21

suppression of normal BM function
malignacy, infection, inflammation
reduced RBC production due to poor EPO, abnormal iron metabolism

Question 22

what molecules can cause normocytic anaemia

Answer 22

inflammatory cytokines (IL-1/6, TNF-a)

hepcidin (made in liver) - inhibits iron from endothelial cells = reduced RBC production

Question 23

what is thrombocytopenia and the common causes

Answer 23

decrease in the number of platelets

drugs, alcohol, toxins
ITP (immune thrombocytopenia purpura)
liver disease
pregnancy 
infection

Question 24

what is the presentation of thrombocytopenia and therapy

Answer 24

bruising and low platelet count (below 30)

steroids or IV IG’s
thrombomimics

Question 25

what is ITP, causes , presentation and theory

Answer 25

immune thrombocytopenic purpura
antibody mediated platelet destruction
children show acute presentations usually with viral infection
bruising and low platelet count

first line T = steroids or Iv IG’s

Question 26

what is TTP, causes and treatment

Answer 26

rare but severe
thrombocytes thrombocytopenic purpura - vWF issue = cause lots of little thrombi
do not give platelets but give steroids