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Y3 CORE CONDITIONS > HAEMATOLOGY > Flashcards

HAEMATOLOGY Flashcards

1
Q

what is the most common cause of microcytic anaemia?

A

iron deficiency

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2
Q

give 2 physiological causes of iron deficiency anaemia

A

increased demand

decreased absorption

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3
Q

give 2 pathological causes of iron deficiency anaemia

A

blood loss

malignancy

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4
Q

give 1 lifestyle cause of iron deficiency anaemia

A

poor diet

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5
Q

give a sign you might see on the hands of someone with iron deficiency anaemia

A

kiolonychia

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6
Q

give a sign you might see on the face of someone with iron deficiency anaemia

A

angular stomatitis

Glossitis

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7
Q

what is plummer vinson syndrome?

A

dysphagia and glossitis w iron deficiency anaemia

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8
Q

what specific blood tests might you suggest for iron deficiency anaemia?

A

ferritin
iron
iron binding

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9
Q

give 2 differential diagnoses for iron deficiency anemia

A

thalassaemia
sideroblastic anaemia
anaemia of chronic disease

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10
Q

what type of iron is better absorbed in the body?

A

haem iron (as opposed to non-haem)

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11
Q

give 4 normal physiological instances where iron in lost in the body(0.5-1mg/day)

A

faeces
sweat
urine
menstruation

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12
Q

when does demand for iron increase in life?

A

growth

pregnancy

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13
Q

give 4 types of macrocytic anaemia

A

megaloblastic
non-megaloblastic
pernicious (B12 deficiency)
folate deficiency

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14
Q

give 3 causes of megaloblastic anaemia

A

vitamin B12 deficiency/abnormal metabolism
folic acid deficiency
DNA defects

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15
Q

give 2 causes of DNA defects in megaloblastic anaemia

A

congenital

drug related - azathioprine

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16
Q

what kind of condition is pernicious anaemia?

A

autoimmune

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17
Q

what is the mechanism for pernicious anaemia?

A

loss of parietal cells, loss of intrinsic factor, malabsorption of B12

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18
Q

what group are most likely to get pernicious anaemia?

a) black, female, overweight
b) black, female, elderly
c) white, male, overweight
d) white, female, elderly

A

d) white female elderly

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19
Q

give 3 iatrogenic causes of folate deficiency

A

methotrexate
trimethoprim
phenytoin

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20
Q

Excess of what can cause folate deficiency?

A

alcohol

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21
Q

give 4 causes of non-megaloblastic anaemia

A

alcohol excess
liver disease
hypothyroidism
drugs (azathioprine)

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22
Q

in which type of macrocytic anaemia might you see neurological changes?

A

B12 deficiency

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23
Q

name 3 neurological changes that might occur with B12 deficiency

A

optic atrophy
dementia
hallucinations
polyneuropathy

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24
Q

what is the pathophysiology of megaloblastic anaemia?

A

delayed nuclear maturation of RBCs in bone marrow - large immature nuclei

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25
Q

what is the pathophysiology of non-megaloblastic anaemia?

A

increased lipid deposit in red blood cell membrane

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26
Q

what is aplastic/fanconi’s anaemia?

A

non megaloblastic, bone marrow failure

27
Q

what is non-megaloblastic polycythaemia?

What is the cause?

A

erythrocytosis
increased red cell count & haemoglobin
Cause is renal cell carcinoma

28
Q

what is the specific defect in polycythaemia vera?

A

JAK2 mutation - stem cell disorder

29
Q

what age group is most prone to polycythaemia vera?

a) infants
b) young adults
c) middle aged
d) over 60

A

d) over 60

30
Q

Give 4 neurological symptoms of polycythaemia vera

A

vertigo
tinnitus
visual disturbances
Depression

31
Q

what locomotor condition can occur in polycythaemia vera?

32
Q

how can alcohol cause macrocytic anaemia

A

increases mean cell volume and is toxic on erythropoiesis

33
Q

what types of macrocytic anaemia can alcohol cause

A

megaloblastic and non megaloblastic

34
Q

which blood tests would you use to distinguish between different types of macrocytic anaemia?

A

to differentiate between B12 and folate

35
Q

what will the blood results of B12 and folate look like in non-megaloblastic anaemia?

36
Q

what drug is given to treat B12 deficiency?

A

hydroxocobalamin

37
Q

what drug is used to treat folate anaemia?

A

folic acid

38
Q

where can folate be naturally found?

A

raw green vegetables

39
Q

what drugs are given to treat pernicious anaemia

A

corticosteroids and hydroxocobalamin IM

40
Q

give a treatment for aplastic anaemia

A

bone marrow transplant

41
Q

What is the most common type of anaemia in pregnancy?

A

Iron deficiency anaemia

42
Q

Why do pre-menopausal females get IDA?

A

Heavy menstrual bleed and pregnancy

43
Q

What is the most common cause of IDA in post menopausal females and males?

A

Blood loss from GI tract

44
Q

What are general physical symptoms of iron deficiency anaemia?

A 
Fatigue
Syncope
SOB
Headache
Angina
Pallor
45
Q

What are the risk factors to IDA?

A

heavy periods

blood loss/bleeding

46
Q

What are DD of iron deficiency anaemia?

A

Thalassaemia, sideroblastic anaemia and anaemia of chronic disease

47
Q

What is sideroblastic anaemia?

A

Bone marrow produces ringed sideroblastic cells rather than health RBC

48
Q

What are the treatments for IDA?

A

Oral iron –> ferrous suphate

Severe IDA= paraenteral iron

49
Q

what sort of infection can cause IDA?

A

Hook worm infection ( ask about travel)

50
Q

What four drugs can increase the likely hood of IDA?

A

Clopidogrel
NSAIDS
SSRIs
Corticosteriods

51
Q

What is megoblastic anaemia?

A

Anaemia caused by large RBC in the bone marrow with a immature nuclei caused by a defective DNA synthesis

52
Q

What is the most common cause of megoblastic anaemia?

A

Pernicious anaemia

53
Q

How is B12 absorbed?

A

Combines with IF that are produced by the parietal cells in the stomach.
IF-B12 complex then attached to IF receptors in distal ilium and is absorbed

54
Q

What physical state makes you prone to folate deficiency and therefore megoblastic anaemia?

A

Pregnancy and lactation

Increase age

55
Q

Where in the body is folate absorbed and how long can it be stored for?

A

Upper part of the small intestine and stored for up to 4 months

56
Q

What excessive action can cause folate and vitamin B12 deficiency?

A

Excessive urination

57
Q

What conditions can cause a person to excessively urinate and therefore have folate deficiency?

A

Acute liver disease (alcoholics), congestive heart failure and chronic dialysis

58
Q

Give examples of conditions where you need increase amount of folate causing folate deficiency?

A

Malignancy
Blood disorders: Thalassaemia and sick cell disease
Infection: Malaria, Chrons and TB
Poor absorption : ceoliac disease

59
Q

What is non megoblastic anaemia?

A

It is a mature large RBC with a normal DNA

Less common

60
Q

Except for neuo changes what are the other signs and symptoms of macrocystic anaemia?

A 
Lethargy,
Fatigue
 Fainting
Jaundice
 Glossitis and angular stomatitis
Pallour
Bleeding
SOB 
Angina
Headache.
61
Q

Do you get any neuro problems with folate deficiency?

A

Mild depression

62
Q

If you have both B12 and folate deficiency which one would you treat first?

63
Q

How do you test that vitamin B12 is due to pernicious anaemia?

A

Check Serum for anti IF antibodies

Y3 CORE CONDITIONS (15 decks)

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