HAEMATOLOGY Flashcards
What is serum ferritin a measure of?
Ferritin is an iron-protein complex found in most tissues, but particularly the bone marrow and reticuloendothelial system.
Serum ferritin is a measure of TOTAL BODY STORES of iron.
The body stores are often low in patients with iron deficiency anaemia.
Ferritin is an acute phase protein so may be raised in inflammatory or malignant disease.
In iron deficiency anaemia, what are the MCV and MCHC likely to be? Raised or lowered?
MCV is LOW (microcytic anaemia)
MCHC is low (mean corpuscular haemoglobin)
In a megaloblastic anaemia, if you’re not sure whether it’s B12 or folate deficiency, what are you likely to recommend?
Schillings test- it detects whether you are absorbing vitamin B12
Positive if its B12 deficient anaemia
Negative if its folate deficient anaemia
From which part of the gut is iron mainly absorbed?
DUODENUM
What is the role of haemoglobin in the body?
Transports oxygen around the body.
Aneamia is characterised by a reduced concentration of haemoglobin or red blood cells in the blood
Why can we see low potassium when treating anaemias?
As K+ is required for the production of new red blood cells.
Do iron-deficient anaemias result in a high or low MCV? Is it microcytic or macrocytic?
LOW MCV
Microcytic anaemia
Microcytic anaemias result from deficient or defective heme or globin synthesis. Usually caused by iron deficiency and thalassemias (a blood disorder).
What kind of anaemia (microcytic or macrocytic/megaloblastic) do vitamin B12/ folate deficient anaemias result in? Why?
MACROCYTIC/MEGALOBLASTIC
Larger cell size/ higher MCV
Caused by impaired DNA synthesis- Vitamin B12 and folic acid required for correct synthesis, deficiency leads to deformity.
In microcytic anaemia, MCV is usually
MCV <80 is classed as MICROCYTIC (Iron deficient)
Macrocytic anaemias have RBCs with a MCV of >____?
MCV over 100 is MACROCYTIC (B12 and folate deficient)
What MCV is classed as Normocytic?
MCV of 80-100= Normocytic
Normal range for haemoglobin in males?
13- 17 g/dL (130-170g/L)
Normal range for haemoglobin in females?
12- 15 g/dL (120- 150 g/L)
What is Mean cell haemoglobin concentration (MCHC)? What is its normal range?
MCHC stands for mean corpuscular (cell) hemoglobin concentration and it is the average concentration of haemoglobin in the red blood cells.
range: 31.5 – 34.5g/dL
What is the Haematocrit?
Measurement of the proportion of blood that is made up of red blood cells/ volume of red blood cells
Where is serum ferritin made? Where is it stored?
Made in the bone marrow. Stored in the liver
Why is TIBC (total iron binding capacity) HIGH in iron deficiency anaemia?
Less iron in the body
Therefore there are more iron binding site available
TIBC therefore goes UP in anaemia (only result that goes up)
Microcytic anaemias: MCV: LOW/HIGH? MCH: LOW/ HIGH? MCHC: LOW/ HIGH? Serum Iron: LOW/ HIGH? Serum Ferritin: LOW/ HIGH? TIBC: LOW/ HIGH?
MCV: LOW MCH: LOW MCHC: LOW Serum Iron: LOW Serum ferritin: LOW TIBC: HIGH (as more binding sites free as iron is low)
Remember only thing that is high in MICROcytic anaemias is TIBC
What is MCH? Whats the difference between MCH and MCHC?
MCH= Mean corpuscular hemoglobin (MCH), or “mean cell hemoglobin” (MCH) is the average mass of hemoglobin per red blood cell in a sample of blood. MCHC is the mean cell hemoglobin concentration- these two readings go hand in hand.
They are LOW in Microcytic anaemias (Low haemoglobin, low iron)
They are Normal/ high in Macrocytic/ megaloblastic anaemias- we don’t have a problem with iron here, but haemoglobin is usually also low.
All anaemias are a result of low haemoglobin.
MCV closely parallels the MCH.
Which type of anaemia displays low MCH and MCHC?
Which one displays high MCH and normal MCHC?
Both macrocytic and microcytic anaemias are a result of low haemoglobin.
In microcytic aneamia, iron is low. MCV is low. This results in low MCH and MCHC.
In macrocytic anaemia, MCV is high, MCH is therefore high and MCHC is normal
What causes anemia in chronic kidney disease?
Lack of production of the hormone ERYTHROPOETIN
As a result, the bone marrow makes fewer red blood cells, causing anemia. Can give patients with End stage renal failure erythropoetin injections