Gen Med

Question 1

Name 6 causes of microcytic anaemia

Answer 1

Thalassaemia
Iron Deficiency
Chronic Disease
Sideroblastic/Sickle Cell
Lead Poisoning

Question 2

By what mechanism does iron deficiency lead to microcytic anaemia?

Answer 2

Less iron, less haemoglobin, less cell content therefore smaller cell (microcytic)

Question 3

What blood results would you expect to see in a microcytic anaemia?

Answer 3

Low Hb

Low MCV

Question 4

Name common causes of iron deficiency

Answer 4

Bleeding (slow, chronic, eg GI bleed, menorrhagia)
Decrease absorption (coeliac disease)
Low in diet
Pregnancy (due to increased demand)
Parasitic infection (tape or round worm)

Question 5

What blood results would you expect in a normocytic anaemia?

Answer 5

Low HB

Normal MCV

Question 6

List 4 causes of normocytic anaemia

Answer 6

Bone marrow failure
Haemolytic anaemia
Renal Disease
After acute blood loss

Question 7

What blood results would you see in a microcytic anaemia?

Answer 7

Low Hb

Higher than normal MCV

Question 8

How can microcytic anaemia be further sub divided?

Answer 8

Megaloblastic

Non-megaloblastic

Question 9

Give 2 causes of megaloblastic anaemia

Answer 9

Folate deficiency

Vitamin B12 deficiency

Question 10

By what mechanism does folate deficiency lead to anaemia?

Answer 10

Decreased folate, therefore decreased purines.
Therefore RBCs precursors have inability to make DNA
Therefore the DNA can’t divide, therefore forms megaloblastic cells

Question 11

Give 3 common causes of folate deficiency

Answer 11

Crohn’s disease
Methotrexate
Pregnancy

Question 12

Give 4 common causes of non-megaloblastic microcytic anaemia

Answer 12

Alcohol
Myelodysplasia
Liver disease
Aplastic anaemia

Question 13

What condition presents with a temporary, painless, loss of vision in one eye? Patients describe a black curtain descending across the eye.

Answer 13

Amaurosis Fugax

Indicative of transient retinal ischaemia

Question 14

How would one manage Amaurosis Fugax?

Answer 14

If caused by atherosclerosis- aspirin

Perhaps carotid endarterectomy

Question 15

If left untreated, what complications may occur from Amaurosis Fugax?

Answer 15

Stroke

Question 16

List 4 types of causes of Amaurosis Fugax

Answer 16

Embolic
Idiopathic
Atherosclerosis/Stenosis
Temporary vasospasm
Giant Cell Arteritis
Optic Neuritis

Question 17

What symptoms may present in Granulomatosis with Polyangitis

Answer 17

General- tiredness, fever, weakness, weight loss
H&N- Nosebleeds, face pain, hearing loss
Renal- haematuria, hypertension, Glomerulonephritis
Resp- cough that doesn’t go away, SOB, chest pain
Eyes- conjunctivitis, double vision
GI- diarrhoea

Question 18

What blood test confirms diagnosis of Granulomatosis with Polyangitis?

Answer 18

ANCA

Anti neutrophil cytoplasmic antibodies

Question 19

How might one treat Granulomatosis with Polyangitis?

Answer 19

Bringing condition under control- cyclophosphamide every 2/3 weeks, steroids daily
Keeping under control- reducing cyclophosphamide and swapping to another less potent

Question 20

A positive ANCA blood test would indicate which rare condition?

Answer 20

Granulomatosis with Polyangitis