FBC Flashcards
If 2 cell lineages are low
Increased suspicion of BM problem
Describe erythropoiesis
Describe leukopoiesis
Describe thrombopoiesis
Renal cells sense hypoxia (anemia, renal artery stenosis) => EPO
Acts on BM => increased red cell prod
-Normal removal of RBCs take place in spleen
Development stimulated by GCSF
TPO from liver continual production in life=> megakaryocytes produce platelets
Stages of iron deficiency
Stage 1 - no Hb changes, MCV, MCH normal
-initially due to Fe stores
Stage 2 - ferritin low
-Hb, MCV, MCH normal
Stage 3 -
- first thing to decrease is MCH
- Hb U100
Stage 4 -
- low MCH, microcytic
- Hb U70
Treatment of Fe deficiency
- definitive
- supportive and SE
Treat underlying cause => correct Fe deficiency
PO Fe - cont to take 3 months after deficiency corrected to replenish Fe stores
Fe rich diet - dark leafy greens, meat, fortified bread
SE - nausea, abdo pain, constipation, diarrhoea
HB
- causes of anemia
- how to assess this
MCV
Microcytic - low
Normocytic - normal
Macrocytic - high
Common causes of microcytic anemia
Fe deficiency (over a chronic period of time)
Thalassemia - not enough Hb
Sideroblastic - Fe can’t be incoorporated into haem
Common causes of normocytic anemia
Anemia of chronic disease (HF, RF) - high hepcidin - blocks Fe uptake, BM can’t uptake EPO
Trauma, bleeds
AI hypothyroid
Pregnancy - dilution of blood
Common causes of macrocytic anemia
Alcoholics => B12 uptake inhibited => Korsakoff
-Pabrinex
Vitamin deficiency - B12, folate
Reticulocytosis => reticulocytes misinterpreted as RBCs
Cytotoxics
MDS
Common causes of Fe deficiency
- prolonged chronic blood loss
- reduced intake/uptake
Heavy periods Pregnancy Haematuria Crohns - chronic occult bleeding uptake here Malignancy Gastritis
Malnutrition - need more green leafy veg, fortified foods
Coeliac disease - reduced Fe uptake
Crohns - haematinics absorbed in terminal ileum
Pernicious anemia - AI IF attack
Hb - causes of polycythemia
Often seen with high haematocrit
Absolute polycythemia (primary, secondary)
-increase in RBC
Relative polycythemia
-decrease in plasma
What are the possible causes of primary polycythemia
-what is the pathophysiology
BM issue => proliferation of RBC precursors
-myeloproliferative neoplasms
What are the possible causes of secondary polycythemia
-what is the pathophysiology
Conditions that increase EPO
MOST COMMON CAUSE
-SMOKING
-ALCOHOL EXCESS
Hypoxia
- COPD, smoking, obstructive sleep apnoea, lung fibrosis
- cyanotic heart disease
Increased EPO
-steroids
PV - BM makes too many RBCs
What are the possible causes of relative polycythemia
Reduction of plasma volume
- low fluid intake
- excess fluid loss
Haematocrit
Percentage of blood sample made up of red blood cells
- affected by no of RBCs or plasma volume
- more sensitive to RBC no changes than Hb
High - hyperviscosity syndrome
- thrombus, headache, blurred vision, chest pain
- need venesection
Reticulocyte count
Immature red cell normally released from bone marrow into peripheral blood
-used to assess bone marrow response to anemia
High in anemia - BM function :), RBCs being destroyed peripherally
Low in anemia - BM function :(
- nutritional deficiencies
- primary BM disorder (malignancy)
High, no anemia - body is compensating for blood loss
