Classification of Anaemia

Question 1

how can anaemia be classified

Answer 1

1) by the morphology of RBC

2) if there is an appropriate response by reticulocytes tot he present pathology

Question 2

what would an appropriate response by reticulocytes to increased RBC destruction by the spleen

Answer 2

more RBCs being produced to counter the loss?

Question 3

is there an appropriate reticulocyte response? NO

Answer 3

look at MCV of the RBC on full blood count

Question 4

MCV

Answer 4

Mean Corpuscular/ cell Volume

The MCV is a value that describes the average size of red blood cells (erythrocytes) in a blood sample

Question 5

how can RBCs be described according to their MCV

Answer 5

Microcytic
Normocytic
Macrocytic

Question 6

therefore if there is NOT an appropriate reticulocyte response what sort of anaemia could it be

Answer 6

Microcytic anaemia

Normocytic anaemia

Macrocytic anaemia

Question 7

is there an appropriate reticulocyte response? YES

Answer 7

ask: is there evidence of haemolysis

Question 8

is there evidence of haemolysis? YES

Answer 8

look fo any possible cause

• shear stress?
• heat damage/ osmotic changes?
• hereditary spherocytosis
• G6PD or pyruvate kinase deficiency
• autoimmune haemolytic anaemia

Question 9

is there evidence of haemolysis? NO

Answer 9

look for signs of bleeding

Question 10

with an appropriate reciulocye response what is seen on a blood film

Answer 10

reticulocytosis

Question 11

reticulocytosis shsows

Answer 11

active bone marrow trying to replace lost RBC rapidly and is seen in:

Excessive bleeding
Splenic sequestration of RBCS
Haemolysis

Question 12

if there isa. low reticulocyte count

Answer 12

means the bone marrow is not functioning as normal and will produce abnormal RBC

Question 13

MCV is reticulocytes are markedly elevated

Answer 13

Reticulocytes are said to be large enough to cause an increase in mean cell volume (MCV) if the percentage is markedly elevated. This occurs in only a small group of subjects with very high reticulocyte percentages—those with chronic immune hemolytic anemia

Question 14

microcytic anaemia

Answer 14

Low MCV <80fL

- characterised by small RBC

Question 15

causes of microcytic anaemia can be summarised by which pneumonic

Answer 15

TAILS

Question 16

Microcytic anaemia: TAILS

Answer 16

• Thalassemia
• Anaemia of chronic disease
• Iron deficiency
• Lead poisoning
• Sideroblastic anaemia

Question 17

T

Answer 17

thalassaemia

Question 18

A

Answer 18

Anaemia of chronic disease (normally normocytic)

Question 19

I

Answer 19

Iron deficiency

Question 20

L

Answer 20

Lead poisoning

Question 21

S

Answer 21

Sideroblastic anaemia (the body has iron but cannot incorporate it into haemoglobin)

Question 22

Normocytic anaemia

Answer 22

normal MCV 80-100 fL

- Size of RBC is normal

Question 23

what is the pathology in normocytic anaemia

Answer 23

haemocrtic and haemoglobin levels are duced

Question 24

cause of normocytic anaemia which cause reduced haemocrit and haemoglobin

Answer 24

• anaemia of chronic disease
• renal failure (no EPO)
• bone marrow failure
• acute blood loss

Question 25

anaemia of chronic disease

Answer 25

associated with chronic infection, inflammatory and malignant disease. This leads to a reduction in serum iron levels, due to a higher amount being taken up by cells.

Question 26

Macrocytic anaemia

Answer 26

high MCV >100 fL

- large RBC

Question 27

large size of RBC in macrocytic anaemia means

Answer 27

there is an insufficient number of cells and also an insufficient amount of haemoglobin per cell.

Question 28

causes of macrocytic anaemia

Answer 28

vitamin B12 or folate deficiency (substances found in diet that are needed for DNA development); liver disease; alcohol excess and some types of haemolytic anaemias.

Question 29

most common type of macrocytic anaemia

Answer 29

megaloblastic macrocytic anaemia

Question 30

megaloblastic macrocytic anaemia

Answer 30

his takes place when the DNA in red blood cells is produced too slowly or not enough.

Question 31

which is the most common type of anaemia

Answer 31

normocytic