Haem- anaemia Flashcards
anaemia
decrease in haemoglobin in the blood
anaemia in adult males level
Hb <130 g/l
anaemia in adult females level
Hb <120g/l
normal response to anaemia
make more red cells- reticulocytosis
reticulocytes
cells that have just left the bone marrow
size of reticulocytes
larger than average red cells
reticulocytes stain-
purple/deep red
symptoms of anaemia
breathlessness
palpitations
headaches
faintness
fatigue
microcytic anaemia
anaemia caused by deficient haemoglobin synthesis (cytoplasmic defect)
most common cause of microcytic anaemia
iron deficiency
which cytokine is released due to chronic disease and causes anaemia
IL6
Sideroblastic anaemia
excess iron buildup in mitochondria due to failure to incorportae iron into haem
iron deficiency more likely in who
women and children
causes of iron deficiency
dietary factors
losing too much- bleeding
not absorbing enough- malabsorption
clinical features of iron deficiency (longstanding)
- Brittle nails
- Spoon-shaped nails (koilonychia)
- Atrophy of the papillae of the tongue
- Angular stomatitis
- Brittle hair
- Dysphagia and glottitis
- Generalised pruritis
megaloblastic anaemia
anemia characterized by the presence of abnormally large red blood cells (megaloblasts) in the bone marrow and peripheral blood
Pernicious anaemia
autoimmune condition with resulting destruction of gastric parietal cells- B12 deficiency
sources of B12
animals
sources of folate
Liver, leafy veg, fortified cereals
where is B12 absorbed
ileum
where is folate absorbed
Duodenum and jejunum
daily requirement of B12
1.5ug/day
daily requirement of folate
200ug/day
clinical features of B12/folate deficiency
anaemia symptoms
weight loss, diarrhoea, infertility
sore tongue, jaundice
neurological problems
thalassaemia
autosomal recessive inherited disorders of haemoglobin, causing reduced global chain synthesis, resulting in impaired haemoglobin production
common conditions causing anaemia of chronic disease
cancer
rheumatoid arthritis
patients diagnosed with microcytic anaemia with red flags for colorectal cancer are given :
FIT test- then may be referred for urgent colonoscopy
low ferritin in which type of anaemia
iron deficiency
% saturation of transferrin is reduced in which types of anaemia
iron deficiency anaemia
anaemia of chronic disease
common cause of B12 deficiency
veganism
most common causes of megaloblastic anaemia
B12 deficiency
follate deficiency
which autoantibody confirms the diagnosis of megaloblastic anaemia
Anti intrinsic factor
blood film findings in megaloblastic anaemia
macrovalocytes
hypersegmented nucleus
clinical features of alpha thalassaemia
fatigue
jaundice
facial bone deformities
oral iron replacement therapy drugs
ferrous sulfate
ferrous gluconate
ferrous fumarate
how long before meals and taking other medications should oral iron supplements be taken
at least 30 mins before a meal
2 hours before taking other meds
what should you avoid taking iron supplements with
milk
caffeine
calcium
antacids
high fibre foods
what is pernicious anaemia associated with
atrophic gastritis
family history pf other autoimmune disorders eg hypothyroidism, Addisons disease
which type of anaemia does frontal bossing occur in
Beta thalassaemia
Beta thalassaemia major age of onset
6-24 months of age
diagnostic test for Beta thalassaemia
Hb electrophoresis
management of beta thalassaemia major
regular (2-4 weeks) blood transfusions for rest of life
blood results in thalassaemia
low Hb
low MCV
in beta thalassaemia major, how many damaged/missing genes for beta-globin are there
2
Severest form of α thalassaemia
Hb Barts Hydrops Foetalis Syndrome
Alpha thalassaemia HbH disease
only one alpha gene left
example of Problems with porphyrin synthesis
sideroblastic anaemia
microcytic cells are hypochromic which means -
lacking in colour
haemolytic anaemia
condition characterised by the destruction or ‘lysis’ of red blood cells
sickle syndromes
group of genetic disorders that affect the structure of haemoglobin, resulting in the production of HbS
sickle cell trait Hb..
HbAS
beta genes in sickle cell trait
one normal, one abnormal b gene
sickle cell anaemia Hb..
HbSS
sickle cell anaemia beta genes
2 abnormal beta genes
vaso-occlusive crisis
acute pain in the hands and feet due to vaso-occlusion of the small vessels
best diagnostic test for sickle cell anaemia
HPLC or electophoresis
acute chest syndrome symptoms
Shortness of breath
chest pain
pyrexia
hypoxia
new chest x-ray changes due to consolidation
core triad of acute chest crisis management
high-flow oxygen
antibiotics (with atypical cover)
exchange transfusion
medication which reduces the frequency and severity of sickle cell crises
Hydroxycarbamide
moa of Hydroxycarbamide
increases the levels of foetal haemoglobin (Hb F) in the blood
sickle cell disease anaemia disease pattern
autosomal recessive
blood count and film in microcytic anaemia
low MCV
low MCH
management of pernicious anaemia
Vitamin B12 injections for life
Inherited haemolytic anaemias
hereditary spherocytosis
hereditary elliptocytosis
thalassaemia
sickle cell anaemia
G6PD deficiency
Acquired haemolytic anaemias
Autoimmune haemolytic anaemia
Alloimmune haemolytic anaemia (transfusions reactions and haemolytic disease of newborn)
Paroxysmal nocturnal haemoglobinuria
Microangiopathic haemolytic anaemia
Prosthetic valve related haemolysis
clinical features of haemolytic anaemia
anaemia
splenomegaly
jaundice
blood film findings in haemolytic anaemia
spherocytes
red cell fragments
Heinz bodies
causes of warm autoimmune haemolytic anaemia
idiopathic
Lymphoproliferative neoplasms
drugs
SLE
which Ig mediates warm autoimmune haemolytic anaemia
IgG
causes of cold autoimmune haemolytic anaemia
Idiopathic
Postinfectious haemolytic anaemia
Lymphoproliferative disorders
which Ig mediates cold autoimmune haemolytic anaemia
IgM
mode of inheritance of G6PD deficiency
X-linked recessive disorder
causes of microcytic anaemia (TAILS)
thalassaemia
anaemia of chronic disease
iron deficiency anaemia
led poisoning
sideroblasic anaemia
