Haem Flashcards
Microcytic anaemia causes
Low iron, thalassaemia, sideroblastic
Sometimes chronic disease
Macrocytic anaemia causes
B12/folate deficiency, chronic liver disease
Normocytic anaemia - low retics
Diamond-Blackfann anaemia, Fanconi’s anaemia, TEC (transient erythroblastosis of childhood)
Normocytic anaemia - high retics
Bleeding, haemolysis, bone marrow infiltrates
Signs of thalassaemia
o Chipmunk facies
o Bony deformities (frontal bossing)
o Dental malocclusion
o Jaundice
o HSM
o Desferroxamine signs (scars, retinopathy, cataracts)
Signs of iron deficiency
Pallor in skin and conjunctiva
Pale atrophic tongue
Angular cheilosis/stomatitis
Leuconychia
Features of bleeding
- Bruises
- Petechiae
- CNS, joints, sputum, urine, stool blood loss
Causes of clotting defects
o Congenital - haemophilia; vWD
o Acquired - liver disease; DIC
Causes of low platelets - congenital
Trisomies
Short statures → Noonan, Turner’s
Abnormal thumbs → TAR, Fanconi’s
Abnormal skin → Wiskott Aldrich
Bernard Soulier
Causes of low platelets - acquired
Marrow infiltration (leukaemia, lymphoma)
Immune (ITP, SLE, alloimune)
Drugs (PHT, valproate, sulphonamides)
Infective (EBV, CMV, HIV)
Metabolic
Consumption (hypersplenism, haemangiomas)
Eczema and lots of bruising
Wiskott Aldrich
Evidence of CLD
Spider naevi, pruritus, jaundice, oedema
Sickle cell anaemia features
Anaemia
Haemolysis → bone, HSM, lymphadenopathy
Sickle cell complications
Vaso-occlusive disease (VOD) -> neuro, resp, CVS, abdo, joints, renal
Aplastic crisis -> increased pallor, URTIs, splenic sequestation, hypotension, generally unwell
Haemolysis -> lymphadenopathy, hepatosplenomegaly, bone expansion +- compression +- fractures, RUQ pain
Anaemia -> cognitive decline, CHF, SOBOE
Features of thalassaemia
- Growth → impaired height, increased HC
- Puberty → delayed
- Dysmorphology → chip-munk facies, protrusion of teeth, frontal bossing
- Hands → pale, periungal pigmentation
- Eyes → jaundice
- Abdomen → HSM, gallstones
- Urinalysis → ↑ urobilinogen