Haematology Flashcards
What is used to diagnose anaemia
Low haemoglobin
If you have a patient with low haemoglobin, what would you then check
Mean cell volume
Normal haemoglobin? For women and men?
Women- 120-165 g/l
Men- 130-180 g/l
Normal mean cell volume
80-100 femtolitres
3 types of anaemia
Microcytic
Normocytic
Macrocytic
Microcytic anaemia causes
‘TAILS’
T- thalassaemia
A- anaemia of chronic disease
I- iron deficiency anaemia
L- lead poisoning
S- sideroblastic anaemia- enough iron but not used —> same effect as iron deficiency
Normocytic anaemia causes
‘3As and 2 Hs’
A- acute blood loss
A- anaemia of chronic disease
A- apastic anaemia
H- haemolytic anaemia
H- hypothyroidism
What type of anaemia can hypothyroidism cause?
Normocytic anaemia
Megaloblastic anaemia causes
B12 deficiency
Folate deficiency
Normoblastic anaemia causes
Alcohol
Reticulocytosis- usually from haemolytic anaemia or blood loss
Hypothyroidism
Liver disease
Drugs e.g. azathioprine
Two types of macrocytic anaemia and difference between them?
Megaloblastic and normoplastic
Megaloblastic- caused by impaired DNA synthesis meaning cell can’t divide normally, instead of dividing just grows
Symptoms of anaemia
Tiredness
SOB
headaches
Dizziness
Palpitations
Worsening other conditions e.g. angina, HF, peripheral vascular disease
Symptoms specific to iron deficiency anaemia
Pica- dietary cravings for abnormal things
Hair loss
Generic signs of anaemia
Pale skin
Conjunctival pallor
Tachycardia
Raised resp rate
Specific signs of iron deficiency anaemia
Koilonychia- spoon shaped nails
Angular chelitis- sores on side of mouth
Atrophied glossitis- smooth tongue due to atrophy of papillae
Brittle hair and nails
What type of anaemia would jaundice indicate?
Haemolytic anaemia
Investigations for anaemia
Haemoglobin
Mean cell volume
B12
Folate
Ferritin
Blood film
Where is iron absorbed
Duodenum and jejunum
Iron needs to remain in the Fe2+ form to be absorbed. What medication can alter this and why?
PPIs
Stomach acid keeps iron in Fe2+ form. Without iron turns to Fe3+ which can’t be absorbed. PPIs can reduce acid and reduce iron absorption
What inflammatory conditions can cause iron deficiency anaemia and why?
Iron absorbed in duodenum and jejenum so inflammation here can reduce absorption.
Coeliac disease
Crohn’s disease
General causes of iron deficiency anaemia
Insufficient dietary intake
Increased iron requirements e.g. pregnancy
Iron lost e.g. slow bleed e.g. colon cancer
Inadequate absorption e.g inflammation in Bowel
Most common causes of iron deficiency anaemia in adults and children
Adults- blood loss
1st- menstruating women
Then, GI tract
Most common: oesophagitis and gastritis
Consider: GI tract cancer, Crohn’s or UC
Children- dietary insufficiency
What carrier protein carries iron around the blood?
Transferrin
What is ferritin
Form iron takes when deposited and stored in cells