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Haematology > classification and features of anaemia > Flashcards

classification and features of anaemia Flashcards

1
Q

When is a person said to have anaemia

A

when the total hb count is less than what is expected for a person of a certain age,gender,and geographical location.

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2
Q

How does geographical location affect hb?

A

higher altitudes present with less oxygen.

people who reside in such areas will develop increased rbc ‘s in order to carry more oxygen.

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3
Q

Is anaemia a disease?

A

Anaemia is not a disease in itself, it is usually secondary to a disease.

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4
Q

General pathophysiology of anaemia

A

decreased hb/rbc–>decreased O2 carrying capacity–>hypoxia or hypoxia induced effect on organ –>signs of anaemia

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5
Q

classification of anaemia

A

Aetiologic

based on morphology

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6
Q

aetiologic causes of anaemia include

A

blood loss

low production of rbc

excessive destruction of rbc

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7
Q

Morphologic classification of of anaemia

A

Macrocytic anaemia
Microcytic hypochromic
Normocytic normochromic

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8
Q

what causes impaired RBC production

A
  1. lack of nutrients required for erythropoiesis ie folic acid, iron,vit B12
  2. Bone marrow failure causing decreased erythropoietin activity
  3. Anaemia cause by chronic conditions, i.e infections, kidney dx ,inflammatory disorders, connective tissue disorders
  4. Aplastic anaemia
  5. Anaemia from replacement of bone marrow. i.e in leukemia or lymphoma
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9
Q

Types of defects in RBC that cause anemia

A
  1. intrinsic defect in RBC ie membrane/Hb
    Congenital ; hereditary spherocytosis, elliptocytosis ;sickle cell, thalassemia, unstable hb dx; pyruvate kinase deficiency, g6pd deficiency
    Acquired ; paroxysmal nocturnal hemoglobinuria
  2. Extrinsic defects
    immune mechanisms; autoimmune acquired hemolytic anaemia;hemolytic dx of the newborn; March hemolytic anaemia
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10
Q

Acquired intrinsic defect that destroys RBC

A

Paraxosymal nocturnal haemoglobinuria

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11
Q

All extrinsic defects are

A

acquired

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12
Q

Paraxosymal nocturnal haemoglobinuria is

A

loss of protein on RBC that prevents it from being attacked by complement

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13
Q

Morphologic classification is based on

A

size

Hb content of RBC

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14
Q

Size of rbc

A

8 microns in diameter

Diameter comparable to the nucleus of a mature lymphocyte

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15
Q

What is it called when the size of RBC is normal

A

Normocytic

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16
Q

When the size of RBC is smaller than normal

A

microcytic

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17
Q

Diameter of RBC is bigger than normal

A

Macrocytic

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18
Q

when Hb content of RBC is normal

A

Normochromic

Normochromic RBCs have an area of central parlor 1/3 its size

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19
Q

Hb content lower than normal

A

Hypochromic

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20
Q

What is mean cell volume

A

Average volume of RBC in blood

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21
Q

Formula to calculate mean cell volume

A

Hematocrit %
………………………….. *10
RBC *10 raised to the power 12 /L

22
Q

Unit for mean cell volume

A

femtolitre

23
Q

Normal range of mean cell volume

A

81-100fL

24
Q

What is mean cell haemoglobin

A

Average weight of hb in RBC

25
Q

Formula for mean cell haemoglobin

A

Hbg/dl
———— * 100
Hematocrit %

26
Q

Unit of mean cell haemoglobin

A

Picograms

27
Q

Normal range of mean cell haemoglobin

A

26-34pg

28
Q

what is mean cell hb concentration

A

Average concentration of hb in RBC volume

29
Q

Formula for mean cell hb concentration

A

hb g/dl
——————- *100
hematocrit %

29
Q

Formula for mean cell hb concentration

A

hb g/dl
——————- *100
hematocrit %

30
Q

unit for mchc

A

grams per deciliter

31
Q

Range for mchc

A

31-36 g/dl

32
Q

What does hematocrit mean

A

fraction of volume of blood that red blood cells occupy

33
Q

hematocrit in males

A

46%

34
Q

Hematocrit in females

A

42%

35
Q

Red cell distribution width

A

Checks range in volume and size of RBC.

Low value means cells are uniform
high value shows cells vary in size, usually due to presence of young RBC which are usually large. occurs in i.e pernicious anaemia; iron deficiency anaemia

36
Q

Range for red cell distribution width

A

11.5%-14.5%

37
Q

poikilocytosis

A

A condition where a number of RBCs are abnormally shaped

38
Q

Formula for red cell distribution width

A

standard deviation of MCV
………………………………………….. *100
MCV

39
Q

Normocytic Normochromic anaemia

A

Characterized by normal MCV,MCH,MCHC

39
Q

Normocytic Normochromic anaemia

A

Characterized by normal MCV,MCH,MCHC

40
Q

Normocytic Normochromic anaemia

A

Characterized by normal MCV,MCH,MCHC

41
Q

Conditions where you’ll find normocytic normochromic anemia

A 
Aplastic anemia
increased plasma volume i.e in pregnancy,overhydration
Blood loss
kidney dx
Anemia due to chronic disease
42
Q

Microcytic hypochromic anemia

A

Characterized by low MCV,MHC,MCHC

43
Q

Conditions associated with microcytic hypochromic anemia

A

thallasemia

lead poisoning

44
Q

Macrocytic anemia

A

Characterized by raised MCV

45
Q

Conditions where Macrocytic anemia occurs

A

Megaloblastic anemia; where bone marrow forms abnormally huge rbcs due to deficiency of folic acid or vitamin b12

46
Q

Approach to anemic patient

A 
take good history
color of urine
history in family
examination of patient
request appropriate investigations
47
Q

History includes

A 
diet
number of pregnancies
menorrhagia
dark urine
unusual bleeding
family history of anemia
48
Q

Physical examination includes

A 
koilonychia of nails
pallor of mucus membrane
Examine mouth for glossitis or any lesions
pedal edema
jaundice
check abdomen for masses/organs
49
Q

Investigations include

A
  1. Reticulocyte count -high amounts mean RBCs are being depleted whiles low amounts mean theres a problem with bone marrow
  2. sickling test and Hb electrophoresis
  3. Blood film - RBCs stained for spherocytes etc
  4. coombs test for antibodies
  5. Thick and thin blood film for malaria and other infections
  6. G6PD test
  7. ESR and CRP test ; elevated in inflammatory conditions and plasma cell myeloma

Haematology (29 decks)

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