Haematology

Question 1

Causes of microcytic anaemia

Answer 1

Iron deficiency
Anaemia of chronic disease
Thalassaemia
Sideroblastic anaemia

Question 2

Causes of iron deficiency

Answer 2

Inadequate intake (diet)
Decreased absorption (malabsorption)
Blood loss (chronic)
Increased demands (e.g. pregnancy)

Question 3

Iron study results in iron deficiency

Answer 3

Low MCV
Low Serum Iron
High Serum TIBC
Low Serum Ferritin

Question 4

Iron study results in anaemia of chronic disease

Answer 4

Low or normal MCV
Low Serum Iron
Low Serum TIBC
Normal or raised Serum Ferritin

Question 5

Iron study results in thalassaemia

Answer 5

Very low MCV
Normal serum iron, TIBC and ferritin

Question 6

Iron study results in sideroblastic anaemia

Answer 6

Low MCV in inherited, raised MCV in acquired (e.g. lead poisoning)
High Serum Iron
Normal Serum TIBC
High Serum Ferritin

Question 7

Causes of megaloblastic macrocytic anaemia

Answer 7

Vitamin B12 deficiency
Folate deficiency

Question 8

Causes of normoblastic macrocytic anaemia

Answer 8

Alcohol
Increased reticulocytes (e.g. in haemolysis/haemorrhage)
Liver disease
Thyroid disease
Myelodysplasia or marrow infiltration

Question 9

Megaloblastic Anaemia

Answer 9

Characterised by large immature RBCs (megaloblasts) and hypersegmented neutrophils (6+ lobes)

Question 10

Blood film features of iron deficiency anaemia

Answer 10

Microcytic
Hypochromic
Anisocytosis
Poikilocytosis

Question 11

Blood film features of anaemia of chronic disease

Answer 11

Normocytic or microcytic
Normochromic

Question 12

Causes of acquired sideroblastic anaemia

Answer 12

Myelodysplasia
Alcohol, lead or isoniazid poisoning
Idiopathic
Malignancy

Question 13

Blood film features of haemolytic anaemia

Answer 13

Polychromasia
Macrocytosis
Spherocytes
Elliptocytes
Fragmented cells or sickle cells

Question 14

Life span of RBCs, platelets and granulocytes

Answer 14

RBCs = 120 days
Platelets = 7 days
Granulocytes = 7 hours

Question 15

Where is erythropoietin produced?

Answer 15

In the peritubular cells of the kidneys and the liver (10%)

Question 16

Symptoms of anaemia

Answer 16

Pallor
Fatigue
Breathlessness
Dizziness
Palpitations
Cold hands and feet

Question 17

Pernicious Anaemia

Answer 17

Autoimmune disorder that results in destruction of parietal cells reducing the production of intrinsic factor. Intrinsic factor is a necessary protein for absorption of vitamin B12

Question 18

What is serum TIBC?

Answer 18

The blood’s ability to attach itself to iron and transport it around the body.

Question 19

By what process does oxygen bind to haemoglobin?

Answer 19

Oxygenation

Question 20

What form of iron exists in haem?

Answer 20

Ferrous (Fe2+)

Question 21

What form of iron exists in methaemoglobin?

Answer 21

Ferric (Fe3+)

Question 22

Angular Stomatitis

Answer 22

Inflammatory condition affecting the corners of the mouth

Question 23

Atrophic Glossitis

Answer 23

Partial or complete absence of filiform papillae on the dorsal surface of the tongue

Question 24

Koilonychia

Answer 24

Spoon-shaped deformity of the fingernail

Question 25

Ferritin

Answer 25

Protein that stores iron in the cells

Question 26

What population is pernicious anaemia more common in?

Answer 26

Northern European, Scandinavian and African descent
Typically affects adults over 60