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Clinical lectures: Yr2 > Classification of Anaemia: Macrocytic, Normocytic, Microcytic types > Flashcards

Classification of Anaemia: Macrocytic, Normocytic, Microcytic types Flashcards

1
Q

What is anaemia?

A

A finding that indicates significant reduction in volume of red blood cells and Hb concentration, resulting in levels lower than normal

The range depends on the patient’s sex and age.

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2
Q

What are common symptoms of anaemia?

A
  • Fatigue
  • Weakness
  • Dizziness/light-headedness
  • Dyspnea (shortness of breath)
  • Cold hands and feet

These symptoms are common and non-specific.

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3
Q

What are less common but more severe symptoms of anaemia?

A
  • Tachypnea (rapid, shallow breathing)
  • Tachycardia (palpitations)
  • Muscle aches and cramps
  • Angina or heart failure due to underlying coronary artery disease
  • Pallor (abnormally pale complexion)
  • Hypotension
  • Reticulocytosis
  • Bruising more easily
  • Dizziness when standing up
  • Pale mucous membranes

These symptoms indicate a more severe condition.

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4
Q

What is reticulocytosis?

A

Occurs when there is destruction/loss of RBCs or increased production by bone marrow

Indicates a response to anaemia or blood loss.

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5
Q

What are the three common reasons why anaemia occurs?

A
  • Reduced number of erythrocytes
  • Reduced total concentration of Hb
  • Abnormally low haematocrit/packed cell volume

Haematocrit refers to the volume percentage/ratio of erythrocytes in blood.

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6
Q

True or False: Acute onset of anaemia typically has milder symptoms than chronic onset.

A

False

Acute onset will have more marked symptoms than chronic onset as the body had time to adapt.

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7
Q

Fill in the blank: The volume percentage/ratio of erythrocytes in blood is called _______.

A

[haematocrit]

Haematocrit is an important measure in diagnosing anaemia.

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8
Q

What can cause tachycardia in anaemia?

A

Increased demand for oxygen due to reduced oxygen-carrying capacity of blood

This can lead to palpitations.

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9
Q

What does pallor indicate in a patient with anaemia?

A

Abnormally pale complexion, often visible under fingernails and mucous membranes

Pallor is a common clinical sign of anaemia.

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10
Q

What is the effect of anaemia on muscle function?

A

Muscle aches and cramps may occur due to inadequate oxygen delivery

This is often a result of reduced erythrocytes or hemoglobin.

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11
Q

What is the relationship between hypotension and anaemia?

A

Hypotension can occur due to reduced blood volume or cardiac output

This is a more severe symptom of anaemia.

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12
Q

What are the two main types of haemolytic anaemia?

A

Haemolytic anaemia is classified into two types: due to reduced erythrocyte production or increased destruction.

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13
Q

How can aplastic anaemia be confirmed?

A

Aplastic anaemia can be confirmed with a bone marrow biopsy.

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14
Q

What is Diamond-Blackfan anaemia?

A

Diamond-Blackfan anaemia is a rare congenital type of aplastic anaemia characterized by defective stem cells.

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15
Q

What can cause acquired defective stem cells?

A

Acquired defective stem cells can be due to the use of drugs, alcohol, or infections.

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16
Q

What factors can lead to an unhealthy microenvironment in the bone marrow?

A

An unhealthy microenvironment can result from damage due to radiation, infections, or lack of space due to scar tissue (fibrosis) or primary or secondary tumours.

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17
Q

How can anaemia be classified by MCV value?

A

Anaemia can be classified into macrocytic, normocytic, and microcytic based on MCV value.

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18
Q

How is MCV determined?

A

MCV is found by comparing the patient’s blood film to another blood film of cells that are similar in size to normocytic RBCs.

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19
Q

What is macrocytic anaemia?

A

Macrocytic anaemia is when MCV is higher than the upper limit of the normal range.

20
Q

How can macrocytic anaemia be classified?

A

It can be classified into megaloblastic and non-megaloblastic anaemia.

21
Q

What characterizes megaloblastic anaemia?

A

Megaloblastic anaemia is characterized by unusually large, structurally abnormal blood cells (megaloblasts) that do not function normally, produced due to impaired DNA synthesis.

22
Q

What are common causes of megaloblastic anaemia?

A

Common causes include B12 (pernicious) or B9 (folate) deficiency anaemia, which are needed for DNA synthesis.

23
Q

What can cause impaired erythrocyte maturation?

A

A lack of B12 or folate can cause impaired erythrocyte maturation.

24
Q

What tests are used to diagnose macrocytic anaemia?

A

Diagnosis can involve blood smear, bone marrow examination, reticulocyte count, serum B12 and folate levels, RBC folate, serum homocysteine, and methylmalonate.

25
Q

What is non-megaloblastic anaemia?

A

Non-megaloblastic anaemia can occur due to liver disorders, hemolysis, blood loss, drugs, alcohol, reticulocytosis, myelodysplasia, and hypothyroidism.

26
Q

What is an example of a condition that can lead to non-megaloblastic anaemia?

A

Myelodysplastic syndrome (MDS) is a group of blood cancers characterized by impaired blood cell maturation.

27
Q

What is normocytic anaemia?

A

Normocytic anaemia is when MCV is within the normal range.

28
Q

What are some causes of normocytic anaemia?

A

Causes include anemia of chronic disease (ACD), acute blood loss, mixed B12/folate and iron deficiency, and bone marrow disorders.

29
Q

What is a specific example of normocytic anaemia?

A

Chronic renal failure can lead to normocytic anaemia due to reduced erythropoietin levels.

30
Q

What is microcytic anaemia?

A

MCV is less than the lower limit of the normal range.

Examples include iron deficiency anaemia (IDA), thalassaemia, anaemia of chronic disease (ACD), lead poisoning, and sideroblastic anaemia.

31
Q

What is sideroblastic anaemia?

A

A disorder where the body produces enough iron but is unable to incorporate it into haemoglobin.

It can be congenital (usually microcytic) or acquired (usually macrocytic).

32
Q

What is the hallmark finding in a bone marrow biopsy for sideroblastic anaemia?

A

Ringed sideroblasts, which are immature red blood cells with nuclei or centres surrounded by rings of iron.

33
Q

What is the hallmark blood film finding in sideroblastic anaemia?

A

Erythrocytes with basophilic stippling and Pappenheimer bodies.

34
Q

What are Pappenheimer bodies?

A

Cytoplasmic granules of iron found in erythrocytes.

35
Q

What are the hallmark iron studies findings in sideroblastic anaemia?

A

Elevated iron, ferritin, transferrin, and sometimes an elevated reticulocyte count.

36
Q

What is the benefit of iron replacement therapy?

A

Can treat iron-deficiency anaemia.

37
Q

What are the complications of iron replacement therapy?

A

Can cause hypersensitivity reactions and anaphylaxis, especially in patients with known allergies, atopic conditions, inflammatory conditions.

38
Q

Who should not use iron replacement therapy?

A

Contraindicated for pregnant women in the 1st trimester, patients with severe renal or hepatic conditions, infections.

39
Q

What are the side effects of iron replacement therapy?

A

Headache, flushing, dizziness, nausea and vomiting, hypertension, arthralgia, myalgia.

40
Q

What is the benefit of B12 replacement therapy?

A

Can treat pernicious anaemia, normocytic anaemia.

41
Q

What are the complications of B12 replacement therapy?

A

Can cause anaphylaxis in patients with cobalt allergy.

42
Q

What are the side effects of B12 replacement therapy?

A

Injection site reaction, nausea and vomiting, headaches, dizziness, flushing.

43
Q

What is the benefit of folate replacement therapy?

A

Can treat folate-deficiency anaemia, normocytic anaemia.

44
Q

What are the complications of folate replacement therapy?

A

Can cause anaphylaxis.

45
Q

What are the side effects of folate replacement therapy?

A

Injection site reaction, loss of appetite, bloating, flatulence, nausea.

46
Q

What is a big risk factor for sideroblastic anaemia?

A

Frequent alcohol intake

Clinical lectures: Yr2 (41 decks)

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