Concepts of Anaemia

Question 1

Definition of anaemia

Answer 1

Reduced red cell mass so low Hb

Question 2

Basic causes of anaemia and associated reticulocyte count (2)

Answer 2

decreased production so low reticulocyte,
or
increased loss or destruction so high reticulocyte count

Question 3

2 causes of anaemia caused by decreased production

Answer 3

hypo proliferative - reduced amount of erythropoiesis,

maturation abnormality - erythropoiesis ineffective, machinery is trying so lots of precursor but not much output

Question 4

2 causes of anaemia caused by ineffective erythropoiesis which is a decreased production anaemia (2)

Answer 4

cytoplasmic defects - impaired haemoglobinisation,

nuclear defects - impaired cell division

Question 5

2 causes of anaemia caused by increased loss or destruction of red cells which is a increased loss/destruction anaemia (2)

Answer 5

bleeding,

haemolysis

Question 6

As it’s difficult to figure out cause of anaemia according to the pathophysiological causes, how do we investigate for anaemia?

Answer 6

By looking at red cell size and haemoglobin content

Question 7

Microcytic anaemia = MCV low, problems with what?

Answer 7

haemoglobinisation

Question 8

Macrocytic anaemia = MCV high, problems with what?

Answer 8

maturation

Question 9

Total red cell mass can not be measured easily so how is anaemia tested? (2)

Answer 9

Haemoglobin concentation,

haematocrit

Question 10

Anaemia cut off points for males - Hb and Hct

Answer 10

Hb <130g/L,

Hct <0.38

Question 11

Anaemia cut off point for females - Hb and Hct

Answer 11

Hb <120g/L,

Hct <0.37

Question 12

How is Hb concentration measured?

Answer 12

By spectrophotometric method by colour

Question 13

How is haematocrit measured?

Answer 13

By calculating the ratio of the whole blood that is red cells if the sample was left to settle. Done by machines adding up the calculated volume of the red cells and take as percentage of overall cells

Question 14

In which situations are Hb and Hct not good calculations of anaemia? (2)

Answer 14

rapid loss of 50% of blood volume e.g. trauma,
or
plasma expansion e.g. by iv fluids so haemodilution

Question 15

How long does it take for reticulocytosis to occur in response to anaemia?

Answer 15

A few days

Question 16

What is the cause for increased reticulocyte count in acutely unwell people who are really sick?

Answer 16

Reticulocytes left out that were being made are left in early, so is not actually an increase in reticulocyte production

Question 17

What parts of RBC are measured in FBC? (4)

Answer 17

Hb concentration,
number of red cells,
concentration of red cells,
size of the red cells (MCV)

Question 18

What parts of RBC are calculated in FBC? (3) Which can be ignored?

Answer 18

Haematocrit,
Mean cell haemoglobin (MCH),
Mean cell haemoglobin concentration (MCC) -ignore this one