Haematology Flashcards
Anaemia flow chart
Memorise slide 7 on anaemia lecture 1
How long does it take for reticulocytes to mature
24 hours
What are reticulocytes used to monitor
Recovery after treatment
What does the reticulocyte count represent?
BM turnover
Causes of low reticulocyte count - hypoproliferative type
▪ Lack of nutrients (Iron, Folic acid, Vit B12)
▪ Chronic diseases
▪ Bone marrow disorder (aplastic anaemia, leukemia)
▪ Bone marrow suppression (chemotherapy)
Cause of high reticulocyte count - hyperproliferative
▪ Hemolytic anaemia
▪ Chronic Blood loss
Difference between central and peripheral anemia
Central : BM defect
Peripheral: dec. prod, inc. destruction, blood loss
What is the use of flow cytometry?
of Peripheral blood and Bone marrow,
determines the type of cell based on the receptors and markers
presented on it’s surface.
Difference between plasma and serum
Serum is after you centrifuge the blood and all coagulation factors have been removed
Algorithm in the case of microcytic anemia
memorise slide 22 of anemia 1 lecture
What is the most important marker for the diagnosis of IDA? What is its signficance?
Ferritin
• LOW = always IDA
• NORMAL = does not exclude iron deficiency
• INCREASED= ? Due to the fact that Ferritin is an acute phase protein, it can be increased in chronic
infections without excluding iron deficiency . In these conditions ferritin loses its importance.
What is the most important caue of iron def in premenopausal women
Uterine Fibroma : benign tumors that usually lead to heavy bleedings
(menstrual disorders such as menorrhagia)
• Endometrial polyp : is a mass in the inner lining of the uterus
These represent the most frequent causes of iron deficiency in
premenopausal women
Site of iron folte an B12 absorption
Dude Is Just Feeling Ill Bro
Types of iron
►Haem iron (animal origin): Fe+2
one stage absorption
• better absorption (20-30%)
• Endocytosis with ΗCP-1 (Heme carrier protein-1)
►Non-Haem iron (plant origin): Fe+3
two stage absorption
• It is necessary the transformation from Fe+3
to Fe+2, in
low↓ pH and in presence of
• a ferrireductase: Dcytb (Duodenal cytochrome B),
• with the transporter DMT-1 (Divalent Metals
Transporter 1)
Where is iron stored and what is stored iron evaluated by
- Heptocytes
- Siderblasts
- Reticuloendothelial cells
- Evaluated by ferritin
What is pica
Where people eat non edible things due to severe IDA
What is plummer vinson syndrome
►Syderopenic dysphagia is a rare disease characterized by difficulty in swallowing due to iron deficiency that leads to 1. Glossitis 2. Angular Cheilitis 3. Esophageal web ►It is a premalignant condition because can lead t o squamous cell carcinoma
Tx of plummer vinson sydrome
- esophageal dilatation
* iron
Lab features of IDA
►Hb ↓, Htc ↓ ►MCV ↓, MCH ↓, MCHC ↓ ►RDW ↑ , RBCs ↓ ►Fe ↓, ►TIBC ↑, ►Transferrin satur.= 𝐹𝑒 𝑇𝐼𝐵𝐶 X 100 ↓ ►Ferritin ↓ ►Soluble Transf.Receptor sTfR↑ ►Log (sTfR /serum ferritin) >2
What is the transferrin receptor affected by
►Affected by the Iron levels:
• It is increased ONLY in Iron deficiency (IDA)
►Not affected by inflammation
• It is normal in Anaemia of chronic disease (ACD)
• very good indicator for differential diagnosis
between IDA and ACD
What is the significance of soluble transferrin receptor
Soluble Transferrin receptor (sTfR) is the
truncated form of the TfR that is liberated
in the serum.
Its serum levels reflect the number of TfR
expressed on cell
Stages of IDA
See slides 41-44
Drugs that induce macrocytosis
Low Vit. B12
Omeprazole
Metformin
N2O
Low folic acid
- methotrexate, hydrea, trimothoprim
- Phenytoin
Normal Vit b12 and folic acid
Zidovudine
Azathioprine
Cytotoxics
Causes of asynchrony between the nucleus and cytoplasm
► Ineffective DNA synthesis
in nucleus immature
► Normal RNA synthesis
in cytoplasm mature
