Haematology - Anaemia

Question 1

What is anaemia?

Answer 1

Low haemoglobin

Question 2

Classes of anaemia

Answer 2

Microcytic

Normocytic

Macrocytic

Question 3

Microcytic anaemia causes?

Answer 3

TAILS

T – Thalassaemia
A – Anaemia of chronic disease (in more advanced stage)
I – Iron deficiency anaemia
L – Lead poisoning
S – Sideroblastic anaemia

Question 4

Normocytic anaemia causes?

Answer 4

3 As and 2 Hs

A – Acute blood loss
A – Anaemia of Chronic Disease
A – Aplastic Anaemia
H – Haemolytic Anaemia
H – Hypothyroidism

Question 5

Macrocytic anaemia causes?

Answer 5

Can be megaloblastic or non-megaloblastic

Megaloblastic - B12 and folate deficiency

Non-megaloblastic:

• Alcohol
• Reticulocytosis (usually from haemolytic anaemia or blood loss)
• Hypothyroidism
• Liver disease
• Drugs e.g. azathioprine

Question 6

Symptoms of anaemia

Answer 6

Tiredness
Shortness of breath
Headaches
Dizziness
Palpitations

Worsening of other conditions such as angina, heart failure or peripheral vascular disease

Question 7

Symptoms specific to iron deficiency anaemia

Answer 7

Pica - craving abnormal things e.g. dirt

Hair loss

Question 8

Signs of anaemia

Answer 8

Pale skin, conjunctival pallor

Tachycardia

Raised RR

Iron-deficiency, can also get:

• Koilonychia
• Angular chelitis
• Atrophic glossitis
• Brittle hair and nails

Jaundice in haemolytic anaemia

Bone deformities in thalassemia

Oedema, hypertension and excoriations on the skin can indicate chronic kidney disease

Question 9

Investigations in anaemia

Answer 9

FBC - for Hb, MCV
B12 
Folate
Iron studies
Blood film

Also OGD, colonoscopy if suspect GI cancer or as part of NICE referral guidelines e.g. aged over 60 with iron deficiency anaemia

Bone marrow biopsy may be needed if the cause is unclear