HAEM - Normocytic Anaemia Flashcards
How would blood results look in bone marrow failure?
Hb Reticulocytes WBC Platelets All equally low
If there are no abnormal blasts in pancytopenic marrow - what is the diagnosis?
Aplastic anaemia
Which infecction can cause cessation of marrow erythropoesis
Parovirus
Def haemolysis
The breakdown of RBC before the end of their normal life span
Intrinsic causes of haemolysis (3)
Haemoglobinopathies - Sickle cell/thalassaemia
Membranopathies - spherocytosis, eliptocytosis
Enzymeopathies
Extrinsic causes haemolysis (5)
Autoimmune - warm/cold Alloimmune - Rhesus, transfusion/transplant Dx - pencillins Parasites - plasmodium Microangiopathic - DICq
Ix normocytic haemolysis
FBC Blood film Coomb's Hb electrophoresis Enzyme assays Plasma haptoglobin and urinary haemosiderin
Signs of haemolysis on blood count
Anaemia w/ incr MCV
Raised bilirubin
Raised se LDH
Reticulocyte count >2%
What are you looking for: haemolysis and Coomb’s test
RBC coated in ab/complement –> immune cause
Use of Hb electrophoresis in haemolysis
ID different haemoglobinopathies
Use of plasma haptoglobin + urinary haemosiderin in haemolysis
If plasma haptoglobin = reduced
And
Urinary Haemosiderin = present
== intravascular haemolysis
Genetic linkage Sickle cell anaemia
Autosomal recessive
What type of Hb is produced in Sickle cell
HbS
Who gets Sickle cell
people of African origin
What are the 2 Sickle cell genotypes
HBSS
HBAS
Which genotype –> Sickle Cell phenotype
HBSS
What positive is there to having the Sickle cell trait?
Protection from Malaria
Diagnosis Sickle Cell anaemia (3)
Guthrie
Sickle cells blood film
Hb electrophoresis (confirms)
Sx SIckle cell anaemia - first few m of life
Anaemia
Acute haemolytic crisis –> bone infarcts + painful dactylitis
What can happen if Acute haemolytic crisis is not treated in SickleCell disease
Splenic infarction –> hyposplenism
Repeated renal infarction –> CKD + CVA
Complications of having Sickle cell disease (6)
Hyposplenism CKD Bone necrosis Chronic leg ulcers Fe overload LT pulmonary damage
Chronic treatment for Sickle Cell disease
Lifelong folate
Pneumococcal vaccine + prophylactic penicillin
Hydroxcarbamide
Life long transfusions + Fe chelate
Cure Sickle cell disease
BM transplant
Why do vasoocclusive crises occur in Sickle cell?
B/C microvascular occlusion
PS vasoocclusive crises occur in Sickle cell (4)
SEVERE PAIN Sometimes : Mesenteric ischaemia Cerebral infarctions Priapism
Precipitants: vasoocclusive crises occur in Sickle cell (4)
Cold
Infection
Dehydration
Hypoxia