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Clinical Pathology > Common Causes of Anaemia and Thrombocytopenia > Flashcards

Common Causes of Anaemia and Thrombocytopenia Flashcards

1
Q

3 common causes of anaemia

A

Iron, B12, folate deficiencies
Haemolysis
Anaemia of chronic disease

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2
Q

2 common causes of thrombocytopenia

A

Immune thrombocytopenic purpura (ITP)

Thrombocytic Thrombocytopenia Purpura (TTP)

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3
Q

When do you get macrocytic anaemia

A

Larger RBCs than normal, less Hb in the blood

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4
Q

Causes of macrocytic anaemia

A 
B12, folate deficiencies
Metabolic abnormalities (thyroid, liver disease)
Marrow damage (alcohol, drugs, marrow disease)
Haemolysis (reticulocytes are bigger than mature RBCs)
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5
Q

MCV in macrocytic anaemia

A

Above normal

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6
Q

Normocytic anaemia

A

A normocytic anemia is defined as an anemia with a mean corpuscular volume (MCV) of 80-100 which is the normal range. However, the hematocrit and hemoglobin is decreased.

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7
Q

Causes of normocytic anaemia

A

Anaemia of chronic disease/inflammatory

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8
Q

3 causes of microcytic anaemia

A

Iron deficiency
Hb disorders
Sometimes chronic disease

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9
Q

Describe the iron balance

A 
No excretion, limited absorption
Controlled at the level of the gut mucosa
Most iron is thus recycled
Absorbed in duodenum
Transported by transferrin
Stored in ferritin
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10
Q

Lab results of iron deficiency

A 
Microcytic anaemia, small pale RBCs. 
Low MCV
Low MCH
Low ferritin
increased hypochromic cell %
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11
Q

3 main causes of iron deficiency

A 
Blood loss
Increased demand (pregnancy, growth)
Decreased intake (diet, malabsorption)
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12
Q

Usual iron deficiency treatment

A

IV iron

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13
Q

Megaloblastic anemia caused by vitamin B-12 deficiency

A

Pernicious anaemia

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14
Q

RBCs big and few

A

Megaloblastic anaemia

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15
Q

3 main causes of megaloblastic anaemia

A

B12 deficiency
Folate deficiency
Alcohol

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16
Q

Why does B12 or folate deficiency result in megaloblastic anaemia?

A

Both involved in DNA synthesis- targets rapidly dividing cells

17
Q

Describe B12 absorption

A

Gastric parietal cells produce acid and intrinsic factor- binds with vit. B12 and internalised in terminal ilium. Well absorbed and stored for years.

18
Q

3 causes of vit. B12 deficiency

A

Nutritional-vegans
Gastric problems (gastrectomy, pernicious anaemia)
Small bowel problems- Crohn’s, TB

19
Q

Describe the absorption of folic acid

A

Absorbed quite well- good diet requied. 4 month body stores.

20
Q

3 main causes of folic acid deficiency

A

Diet
Malabsorption
Increased usage (pregancy, haemolysis, inflammatory disorders)

21
Q

Autoimmune disease where you have antibodies targeted against parietal cells/intrinsic factor

A

Pernicious anaemia

22
Q

An example of an effect severe B12 deficiency can have on the myelination of peripheral nerve, reversible

A

Subacute combined degeneration of the cord (SADC)

23
Q

3 main causes of haemolytic anaemia

A

Things go wrong on the inside, membrane or outside of the RBC

24
Q

What causes of haemolytic anaemia affect the inside of the RBC

A 
Sickle cell
Enzyme defects (G6PD)
25
Q

Cause of haemolytic anaemia that targets the RBC membrane

A

Hereditary spherocytosis

26
Q

Cuases of haemolytic anaemia outside of the RBC

A

Antibodies
Drugs/toxins
Heart valves
Vasculitis (damaged endothelium)

27
Q

Features of anaemia of chronic disease

A

Normal MCV
Decreased RBC production due to abnormal iron metabolism
Poor erthropoetin response

28
Q

Describe the pathology of anaemia of chronic disease

A

Effects are mediated by the release of inflammatory cytokines (particularly IL-6) which affect hepcidin and results in alteration in iron absorption and release from macrophages

29
Q

Diagnosis of anaemia of chronic disease

A

Normal MCV
Raised inflammatory markers
Normal/high ferritin and low serum iron

30
Q

Causes of thrombocytopenia

A 
Alcohol, drugs
Viral infections
ITP (Immune thrombocytopenia)
Liver disease
Coagulation disorders (DIC)
31
Q

Low platelet disorder-diagnosis of exclusion

A

Immune thrombocytopenic purpura

32
Q

How does the presentation of immune thrombocytopenic purpura vary between children and adults?

A

Children-self limiting, usually no treatment

Adults-chronic or relapsing/remitting

33
Q

Small, non blanching subcutaneous haemorrhages

34
Q

Treatment of immune thrombocytopenic purpura

A

Steroids
Splenectomy (platelets covered with antibiotics are removed in the spleen, without the spleen, no removal and platelet count rises)
Immunosuppressives
Thrombopoetin-stimulate platelet production

35
Q

Thrombocytopenia and fever, neurological symptoms or haemolysis

A

Thrombotic thrombocytopenic purpura

36
Q

Hb value for anaemia in men and women

37
Q

In what circumstances would you get an elevated erythrocyte sedimentation rate?

A

Increased concentration of immuno-globulins and fibrinogen e.g. in inflammatory and neoplastic conditions

Clinical Pathology (53 decks)

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