Common cause of Anaemia and Thrombocytopenia

Question 1

what does MCV stand for?

Answer 1

mean cell volume, relating to how big the red blood cell is

Question 2

what are the causes of anaemia other than blood loss?

Answer 2

haematinic deficiency 
secondary to chronic disease
haemolysis 
alcohol 
drugs 
toxins
renal impairment EPO
primary haemological /marrow disease

Question 3

what are the causes of anaemia when the MCV is normacytic?

Answer 3

anaemia of chronic disease/inflammatory

Question 4

what are the causes of anaemia when the MCV is microcytic?

Answer 4

iron deficiency

haemoglobin disorders

Question 5

what is the most common cause of anaemia

Answer 5

iron deficiency

Question 6

why do you get iron deficient?

Answer 6

• we dont absorb iron well and the body does not have a way to get rid of iron and therefore we can only absorb only small amounts of iron.

Question 7

what are some lab tests to establish low Iron?

Answer 7

FBC, indices and film 
Ferritin - checks iron storage
% hypochromic cells 
serum iron/TIBC 
Marrow

Question 8

what does a blood film show if anaemia?

Answer 8

we would see small pale red blood cells

Question 9

what are the main causes of anaemia/low deficiency?

Answer 9

blood loss
increased demand
reduced intake

Question 10

what are the main causes of anaemia in young women?

Answer 10

menstrual loss/problems
pregnancy
diet

Question 11

what are the main causes of anaemia in older people

Answer 11

bleeding and malignancy

Question 12

what are the main therapies for anaemia treatment?

Answer 12

oral iron
IM iron
IV iron - increasingly used

Question 13

what is megaloblastic anaemia?

Answer 13

a characteristic cell morphology caused by impaired DNA synthesis

Question 14

what are the causes of megaloblastic change?

Answer 14

B12 or Folic acid deficiency 
alcohol 
drugs - cytotoxics/folate antagonists/N2O
malignancy 
congenital rarities

Question 15

how is vitamin B12 absorped?

Answer 15

Go over pathway

gastric parietal cells
intrinsic factor and receptors in terminal ileum

Question 16

what are the main causes of B12 deficiency

Answer 16

nutrional
gastric problems
small bowel problems, crohns, tb

Question 17

what are the main sources of folic acid

Answer 17

mainly in green vegables, bens, peas, nuts and liver

Question 18

what are the main causes of folic acid deficiency?

Answer 18

mainly dietary

Question 19

what are the common features of b12 or folate deficiency?

Answer 19

sterility 
anorexia
glossitis 
mild jaudice
pancytopenia 
megaloblastic anaemia

Question 20

what is the classic cause of B12 deficiency

Answer 20

pernicious Anaemia

Question 21

what are the common causes of haemolysis

Answer 21

things wrong inside the red cell
things wrong with the red cell membrane
things wrong with the outside og the red blood cell

Question 22

what are the common causes of haemolysis that occur within the rbc?

Answer 22

haemoglobinopathy (sickle cell)
enzyme defects (G6PD)

Question 23

what are the dangers of diagnosising an older patient with anaemia of chronic disease?

Answer 23

could miss a malignancy especially bowel cancer.

Question 24

what are the common causes of thrombocytopenia?

Answer 24

• drugs/alcohol/toxins
• ITP - absence of platelets difficult to have a definitive diagnosis.
• other autoimmune diseases
• liver disease
• pregnancy
• haematological/marrow diseases
• infections acute
• disseminated intravascular coagulation (DIC)
• congenital conditions
• many others

Question 25

what is ITP

Answer 25

a common immune disorder

Question 26

what are the causes of ITP?

Answer 26

occurs on its own,
other autoimmune diseases
lymphomas/cLL
HIV

Question 27

what is the presentation of ITP

Answer 27

Bruising, petechiae or bleeding
platelet count can be anything
prodome
exclude other causes

Question 28

what is the fisrt line for ITP

Answer 28

steroids are the first line

Question 29

how can we very definitively tell someone has TTP?

Answer 29

look down microscope