Haematology Flashcards
Causes of MICROCYTIC ANAEMIA (10 causes)
IRON DEFICIENCY of varying cause:
- Menorrhagia
- Pregnancy
- GI Malignancy
- Oesophagitis
- GORD
- Coeliac Disease
- Hookworm
- THALASSAEMIA
- SCHISTOSOMIASIS
- Diet low in Iron
Causes of MACROCYTIC ANAEMIA (6 causes)
FAT RBC
- FOLATE deficiency
- Alcohol
- Thyroid LOW
- RETICULOCYTOSIS
- B12 deficiency- Pernicious Anaemia
- CYTOTOXIC drugs
Causes of NORMOCYTIC ANAEMIA (6 causes)
HAEMOLYTIC ANAEMIA of varying cause-
- Glucose-6-phosphate dehydrogenase deficiency
- Sickle Cell disease
- Hereditary SPHEROCYTOSIS
- ERYTHROBLASTOSIS FETALIS
- Warm antibody AUTOIMMUNE haemolytic anaemia and cold agglutin disease
- Anaemia of chronic disease (Rheumatoid Arthritis, Aplastic Anaemia)
Signs of Microcytic and Macrocytic Anaemia
Pallor
Angular Cheilitis- (inflammation on corners of mouth)
Atrophic Glossitis- (lack of white stuff on tongue)
MICROCYTIC ONLY- Koilynychia
MACROCYTIC ONLY- Paraesthesiae and Subacute degeneration of SPINAL CORD
Bloods in MICROCYTIC ANAEMIA
LOW Hb LOW MCV LOW MCH LOW Ferritin LOW Iron
HIGH Total Iron Binding Capacity
Bloods in MACROCYTIC ANAEMIA
LOW B12 LOW Folate LOW RETICULOCYTES LOW Platelets (If Severe) LOW WCC (If Severe)
HIGH MCV
Bloods in NORMOCYTIC ANAEMIA
LOW Hb
NORMAL MCV
NORMAL or HIGH FERRITIN
Which anaemia increases risk of infection?
MICROCYTIC
Which anaemia can lead to SPLENOMEGALY and neuropsychiatric/ neurological complications?
MACROCYTIC
Treatment for Microcytic and Macrocytic Anaemia
TREAT CAUSE
Microcytic-
- Ferrous Sulphate
Macrocytic-
- HYDROXOCOBALAMIN INJECTIONS if Pernicious Anaemia
BLOODS in THALASSAEMIA
LOW HB
LOW MCV
LOW MCH
NORMAL Ferritin
NORMAL Iron
Hb electrophoresis- HIGH HbA2 and HIGH HbF
Treatment of THALASSAEMIA
Transfusions are required when Hb<7g/dL or when patient is HIGHLY SYMPTOMATIC
Patients who have repeated transfusions regularly are at risk of HAEMOCHROMATOSIS and require IRON CHELATION THERAPY (like DESFERROXAMINE)
Surgical:
- Stem cell transplant
- Splenectomy
Complications of THALASSAEMIA
SPLENOMEGALY
Iron overload
GALLSTONES
ARRHYTHMIAS
Bone abnormalities (CRANIAL BOSSING)
The four steps of CLOT FORMATION
1) Vessel construction
2) Platelet adhesion and aggregation
3) Blood coagulation
4) Fibrinolysis
Glanzmann’s thrombasthenia (DEFECT in STEP 2 of clot formation)
+ investigation
- Platelets are deficient of Gp IIb/IIIa
Investigations- increased bleeding time
Treatment of Glanzmann’s thrombasthenia
- Avoid ASPIRIN and NSAIDs
- DESMOPRESSIN
- Recombinant activated factor VII
Von Willebrand disease (DEFECT in STEP 2 of clot formation)
- Defect in Von Willebrand factor- which binds GpIb on platelets to subendothelial collagen
Investigations in Von Willebrand disease
LOW VWF antigen
LOW factor VIIIc
NORMAL Prothrombin Time
INCREASED bleeding time
INCREASED activated PARTIAL THROMBOPLASTIN time
Treatment of Von Willebrand disease
Avoid ASPIRIN and NSAIDs
DESMOPRESSIN
Bernard Soulier Syndrome (DEFECT in STEP 2 of clot formation)
GpIb deficiency
Investigations in Bernard Soulier Syndrome
Increased bleeding time
NORMAL or LOW platelet
Treatment for Bernard Soulier Syndrome
DESMOPRESSIN
Recombinant activated factor VII
Haemophilia (DEFECT in STEP 3 of clot formation)
Two types-
Type A- lack of FACTOR VIII
Type B- lack of FATOR IX
Investigations in Haemophilia
INCREASED partial thromboplastin time
INCREASED prothrombin
