Common causes of anemia and trombocytopenia

Question 1

Haemantic deficiency: IRON
(small pale red cells)
no excretion of iron. in meat, leafy greens and mussles

Answer 1

causes: blood loss anywhere in gut, resp tract, increased demand due to preg/growth, malabsorption/menstrual loss
common clinical features: weak, pale, tired
Lab tests: FBC, ferritin, % hypochromic cells and marrow
Treat: IV IRON

Question 2

Haemantic deficiency: VITAMIN B12

–> megoblastic anaemia

Answer 2

causes: e.g immune attack on IF/ parietal cells or diet lacking or pernicious anemia,/ gastrectomy / chrons
common clinical features: megablastic anemia –> can have pancytopenia (all cells are deficient)
Mild jaundice, angular stomatis, anorexia, weight loss, sterility.
B12 is essential for cell folate generation and folate is needed for synthesis of dna bases.

Question 3

Haemantic deficiency: FOLATE

Folic acid mainly found in in diet.

Answer 3

causes: malabsorption / small bowel disease / increased usage, haemolysis, inflammatory disorders, drugs/alcohol
common clinical features: megablastic anemia –> can have pancytopenia (all cells are deficient)
Mild jaundice, angular stomatis, anorexia, weight loss, sterility.

Question 4

SACDC- sub acute combined degeneration of the cord

Answer 4

any cause of severe b12 deficiency can cause this
reversible neurological deficit –> demylination of dorsal and lateral columns. presents as unsteady walking, dementia, numbress.
Treatment = b12 and folate.

Question 5

Anameia and chronic disease:

Answer 5

can be due to malignancy/ infllammatory
Reduced red cell production due to abnormal iron metabolism, poor erythropoeiten response and blunted marrow response. These effects are mediated by cytokines an dhepcidin which is a regulator of Fe.
Treatment: Erythropetin, Fe IV or transfusion.

Question 6

types of anaemia

Answer 6

Macrocytic: b12, folate, metabolic, marrow damage.
Normocytic: anaemia of chronic disease
Microcytic: iron deficiency, haemoglobin disorders,

Question 7

Elevated erythrocyte sedimentation rate

Answer 7

measure of the speed that rbc fall to the bottom of a tube. non-specific marker for infections, cancer and autoimmune diseases.

Question 8

Haemolysis

Answer 8

= shortened red cell life

• things go wrong inside the cell: haemoglobinopathies ie sickle cell
• things go wrong with the red cell membrane: hereditary spherocytosis
• things go wrong external to red cell: antibodies, drugs, toxins, heart valves and microangiopathy.

Question 9

Thrombocytopenia (lack of platelets)

Answer 9

Common cause: drugs, alcohol, toxins,
ITP: immune thrombocytopenia purpura- low platelets causing bruising and petachae, platelet cound could be as low as 10.
Therapy = steroids
TPP: thrombotic thrombocytopenia Purpura
MEDICAL EMERGENCY
fever, anaemia, neurological symptoms and haemolysis.