GM: Haematology Flashcards
What causes a normocytic anaemia?
Anaemia without altered RBC structure
Anaemia of chronic disease
Acute blood loss
Aplastic anaemia
Haemolytic anaemia
What are the causes of microcytic anaemia
Thalassaemia: AR defects of haem chains
Anaemic of chronic disease
Iron deficency:can also be normocytic
Lead poisoning: blocks heme synthesising enzymes
Sideroblastic: Iron wont fit into RBCs
How do you investigate iron deficiency anaemia?
FBCs showing low Hb, can confirm if low ferritin
What is the initial management of iron deficiency anaemia?
- oral iron
+ IV iron or blood transfusion
For anaemia, when do you refer to…
Haematology
Supplementation fails to increase by 20g/L over 2-4 weeks and no GI or Gynae criteria
Paraesthesia, changes to mood and vision+/- mild jaundice suggests which anaemia?
B12 deficiency
What investigations suggest B12 deficiency
Macrocytic anaemia
Hypersegmented polymorphs
Low cobalamin is B12, low folate is folate
![](https://s3.amazonaws.com/brainscape-prod/system/cm/389/754/813/a_image_thumb.jpg?1657383394)
How do you treat B12 deficiency?
No neuro: IM hydroxycobalamin 3x day 2 weeks; 1 per 3 months afterwards
Neuro: IM 1mg every other day until improves
TREAT B12 BEFORE FOLATE
give folic acid 5mg day 4 months
When do you refer a vit B12 deficiency to…
Haem
Gastro
Haem: Uncertain, malignancy, resistant to treatment
Gastro: IBD, malabsorption, GI malignancy
How doe sickle cell present on…
FBC
Blood film
Microcytic anaemia
Sickle cells, howell-Jolly bodies
![](https://s3.amazonaws.com/brainscape-prod/system/cm/389/755/278/a_image_thumb.jpg?1657397319)
Outline the inheritance of sickle cell anaemia
AR inheritance of HbS instead of A.
One gene casues trait
Two causes disease
Compare vaso-occlusive, splenic sequestration, aplastic crisis and acute chest syndrome in terms of…
Pain
Associated symptoms
Lab findings
VOC // SS // AC // ACS
Localised pain // abdo pain // painless // painless
Fever, priapism // HSM, hypotension // infective Hx // Resp symptoms
Raised Hc // Severe anaemia // severe anaemia // Infiltrates on X-ray
How do you treat sickle cell crises?
Admit
Treat infection
IV fluids
Keep warm
Analgesia
Aspirate if priapism
What prophylaxis is given to sickle cell patients
Penicillin 3m-5yrs
PPV23 every 5 years
MenB + ACWY then another MenB 4 weeks later
What patient features might point towards thalassaemia?
Pronounced forehead and jaw
Jaundice, gallstone, splenomegaly
How do you diagnose thalassaemia?
Haem electrophoresis
DNA testing