Haematology

Question 1

What are the possible mechanisms responsible for haemoglobin (Hb) fall?

Answer 1

Reduced production of cells (due to b12, folate and Fe deficiency,meds,chronic disease - kidney failure)
Increased destruction (body actively destroys its own blood cells - sickle cell anaemia)
 Blood loses (most common)

Question 2

List the formation of RBC

Answer 2

1.Precursor in bone marrow
2.turns into erythroblast–> normoblasts –> reticulocytes (1 day survival)
3.lose more DNA and RNA and become erythrocytes
4.erythrocytes (long life survival - no need for mitochondria)
, haemoglobin
5. Body cannot eliminate iron

Question 3

Which words do we use to classify size and colour of RBC

Answer 3

Size - micro/macro cystic

Colour - normo/hypo chromic

Question 4

Which anemia is caused by iron deficiency (due to blood loss or increased demands of blood)?

Answer 4

Hypo chromic microcytic

Question 5

What are the Tx options for hypochromic microcytic anaemia?

Answer 5

Supplement iron
Ferrous sulphate in empty stomach
Iron infusion
Monitor after 2-4weeks

Question 6

How to investigate which type of anaemia?

Answer 6

Iron studies (yield ferritin)
STFR (if pt has chronic disease)
B12, folate, FOBs level check
Endoscopy and colonoscopy for GIT bleeding

Question 7

What happens in macro cystic anaemia?

Answer 7

Accumulation of normoblast and reticulocytes, differentiation is stopped

Question 8

What can cause macro cystic anaemia?

Answer 8

Vitamin b12/ folate deficiency that is needed for differentiation
Poisons or genetic defects

Question 9

What does B12 do?

And how can we get B12 deficiency?

Answer 9

B12- it has a role in sustaining myelin so it’s deficiency can cause CNS effects

It’s absorption can be inhibited by lack of gastric intrinsic factor due to medication use (PPI, potassium supplements…)

Question 10

What does folic acid do?

And how can we get folic acid deficiency?

Answer 10

Folic acid is responsible for single carbon unit transfer and purine and pyramidine synthesis