General Anaemia Overview (Red Cells 2) Flashcards
What is anaemia?
When you’re haemoglobin is below normal for your age and sex
What should your haemoglobin levels be as a male 12-70?
140-180
What should your haemoglobin levels be for >70?
116-156
What should your haemoglobin levels be for a female 12-70?
120-160
What should your haemoglobin levels be for a female >70?
108-143
Why have males got a higher haemoglobin count?
due to the presence of androgens
What are the general features of anaemia?
Cause = reduced oxogen delivery to the tissues
- tiredness
- breathlessness
- ankle oedema
- dizziness
- chest pain
what does jaundice signify?
that you’re breaking down haemoglobin too fast and theres too much UNCONJUGATED haemoglobin in your blood.
What are signs of bleeding?
dyspepsia
peri rectal bleeding
what are signs of malabsorption?
weight loss
diarrhoea
What is MCV?
Mean cell volume (size)
82-100
What is MCH?
Mean cell haemoglobin
MCH = 27-32
what are the types of cells found in anaemia?
- Hypochromic, microcytic
- Normochromic, Normocytic
- Macrocytic
What are examples of hypo chromic, microcytic anaemias?
Iron deficiency anaemia
Thalassaemia
Secondary anaemia
What are examples of normochromic, normocytic anaemias?
Haemolytic anaemia Hereditary spherocytosis G6PD deficiency Sickle cell disease Auto-immune haemolytic anaemia Severe infection Secondary anaemia Hypoplasia Marrow infiltration Leukaemias Haemorrhage
What are examples of macrocytic anaemia?
B12 deficiency (usually pernicious anaemia) Folate deficiency
What is the total iron in the body?
4g
How does the body obtain iron?
Most iron is recycled.
New iron is absorbed at the duodenum.
Where is iron taken up?
At the duodenum.
Into the bone marrow - to make RBCs.
into the muscles - where its used.
Into the liver - where excess is taken to be stored.
Which molecule binds to iron to transport it through the plasma?
Transferrin - binds to iron in the plasma as a transport molecule.
Which molecule does iron bind to which allows it to cross the cell membrane?
Ferroprotein
Which molecule does iron bind to which allows it to be stored?
Iron binds to ferritin and is stored in the liver.
which molecule controls iron movement around the body?
Hepcidin - blocks ferroprotein from moving iron out of the cell membrane to be used.
When is hepcidin made?
Hepcidin is made when theres enough iron in the bone marrow and muscles.
When there snot enough iron, hepcidin is turned off.
When is hepcidin also increased?
It is increased when theres enough iron in the body.
AND during inflammation - this is why you can have anaemia (because your cells are not getting enough iron) - despite you having large enough iron stores.
What is pancytopenia?
Low levels of ALL blood cell types:
Red blood cells
White blood cells
Platelets
When should you be wary of giving blood transfusions in someone with anaemia?
When it has been a chronic condition and the patient has become physiologically adapted to the anaemia.
Because you could induce heart failure.
So you should only give 1 unit of blood to begin.
If someone is haemolysing what blood levels will be altered?
Low haptoglobin (as free haemoglobin will have increased and bound to it) High reticulocyte count
What does a DAGT/DAT positive result mean?
There are antibodies on the surface of red blood cells = immune haemolysis.
What is common about most people with sickle cell disease?
Their spleen doesn’t function as they age (hyposplenic).
What is a dangerous side effect of blood transfusion?
Iron deposition in the endocrine organs and the heart.
Treatment is chelation therapy.
What are examples of macrocytic anaemia?
B12 deficiency (usually pernicious anaemia) Folate deficiency Alcohol abuse Drug-induced Congenital bone marrow failures
