HAEMATOLOGY

Question 1

In what condition does Parovirus B19 trigger an aplastic crisis: SOB, Dizziness, Pale, Normocytic Anaemia and Panyctopenia

Answer 1

Hereditary Spherocytosis

Question 2

Haemachromatosis

What two factors are used to monitor treatment in Haemochromatosis?

Answer 2

Ferritin and Transferrin Saturation

Question 3

Haemachromatosis

What are the iron levels in Haemochromatosis?

Answer 3

Raised Transferrin saturation and Ferritin with Low Total Iron Binding Capacity

Question 4

Haemachromatosis

Describe what is Haemachromatosis and how the blood results are caused?

Answer 4

AR disorder- of iron absorption and metabolism- reuslting in iron accumulation-symptoms include- fatigue, erectile dysfunction, arthralgia, bronze skin and DM
Cause: FERRITIN represents IRON STORES» in haemachromatosis there is excess iron deposited in tissues (heart, liver and pancreas)- leads to increases storage of iron with ferritin»> serum ferritin levels reise» TIBC represents max amount of iron that can be bound TF» in haemachromatois the increase in iron saturates the TF» making the TIBC low» TF transports iron in b;ood» in haemachromatosis> the increasediron levles cause an increase in Transferrin saturation+ blood results in haemachromatosis

Question 6

Sickle Cell Anaemia

Describe the difference between aplastic crisis and sequestration crisis?

Answer 6

Aplastic Crisis: Reduced Reticulocytes- bone marrow suppression due to Parovirus infection»rise in WCC and decrease in reticulocytes
Sequestration crisis: Increased Reticulocytes> occurs when blood pools in organs due to sickling occuring» this can cause worsenig of anaemia due to loss of blood in vasculature and increase in reticulocytes as body compensatates foe blood loss» no occlusion of vessels

Question 7

Sickle Cell Anaemia

Name the different types of crises that can occur in sickle cell anaemia and what occurs in each crises?

Answer 7

1. Thrombotic (vaso-occlusive)-painful crises» precipitated by infection, dehydration or deoxygenation» can be diangoses clinically» infarcts occur in various organs: bones-avascular necrosis of hip, hand-foot syndrome in children, spleen, lungs and brain
2. acute chest syndrome: vaso-occlusion with pulmonary vasculature-infarction in lung parenchyma»>dyspnoea, chest pain and pulmonary infiltrates on C-XRAY, low pO2»>Management: pain relief, resp support like O2, antibiotics (infection cause), transfusion
3. anaemic: aplastic (caused by infection with parovirus)»sudden fall in Hb and bone marrow suppression causes reduced ret count and sequestration: sickling within organs such as spleen or lungs>causing pooling of blood»worsening anaemia»assoc with high ret count
4. infection