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Year 5 path > haematology - anaemia > Flashcards

haematology - anaemia Flashcards

1
Q

Hb values if anaemic

A

M: <135 g/L

F: <115g/L

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2
Q

general causes of anaemia

A

↓ RBC production
↑ RBC loss
↑ plasma volume

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3
Q

general symptoms of anaemia

A 
fatigue
dyspnoea
faintness
palpitations
headache
tinnitus
anorexia
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4
Q

general signs of anaemia

A

pallor
hyper dynamic circulation (tachycardia)
flow murmurs (HF)

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5
Q

high MCV suggests

A

↓ RBC production

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6
Q

low MCV suggests

A

normal RBC count but low content

eg. iron deficiency, thalassaemia

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7
Q

causes of microcytic anaemia (FAST)

A

Fe deficiency
anaemia of chronic disease
sideroblastic anaemia
thalassaemia

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8
Q

causes of normocytic anaemia

A

acute blood loss
haemolysis

anaemia of chronic disease
bone marrow failure
renal failure

hypothyroidism
pregnancy

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9
Q

causes of microcytic anaemia (FT MR. ABC)

A 
fetus (pregnancy)
thyroid (hypo)
myelodysplastic syndromes
reticulocytosis
antifolates
B12/folate deficiency
cirrhosis
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10
Q

signs of IDA

A 
koilonychia
atrophic glossitis
angular chelosis
post-cricoid webs (PV syndrome)
brittle hair and mails
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11
Q

IDA blood film

A 
microcytic
hypochromic
anisocytosis
poikilocytosis
pencil cells
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12
Q

IDA classification

A

blood loss - GI bleed

intravascular haemolysis - chronic Hb loss

↑ use - pregnancy/lactation, child growth

↓ intake - diet, prematurity

↓ absorption - coeliac, post gastric surgery

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13
Q

treatment of IDA

A

treat cause
oral ferrous sulphate
IV Fe if severe symptomatic anaemia

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14
Q

treatment of IDA in sepsis/severe infection

A

transfusion

  • Fe will not absorb well
  • Fe can fuel sepsis
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15
Q

side effects of oral Fe

A

nausea
abdominal discomfort
diarrhoea/constipation
black stools

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16
Q

anaemia of chronic disease is

A

cytokine driven inhibition of RBC production

17
Q

inflammatory markers involved in anaemia of chronic disease

A

IFNs
TNF
IL1

IL6
LPS

18
Q

role of IFNs, TNF, and IL1 in anaemia of chronic disease

A

reduce EPO receptor production and EPO synthesis by kidneys

19
Q

role of IL6 and LPS in anaemia of chronic disease

A

stimulates liver to make hepcidin
inhibition of transferrin
decreased iron absorption from gut
iron accumulation in macrophages

20
Q

ferritin in anaemia of chronic disease

A

high

Fe held in macrophage to deprive invading bacteria

21
Q

anaemia of chronic disease in renal failure is

A

not cytokine driven

due to EPO deficiency

22
Q

sideroblastic anaemia

A

ineffective erythropoiesis

  • iron loading haemosiderosis
  • endocrine, liver, and cardiac damage
23
Q

diagnosis of sideroblastic anaemia

A

ring sideroblasts seen in marrow

erythroid precursors with iron deposited in mitochondria in a ring around nucleus

24
Q

causes of sideroblastic anaemia

A 
myelodysplastic disorders
myleoproliferative disease
chemotherapy
irradiation
alcohol excess
lead excess
anti-TB drugs
25
Q

treatment of sideroblastic anaemia

A

remove cause

pyridine (vit B6 - promotes RBC production)

26
Q

iron, TIBC and ferritin in IDA

A

iron - low
TIBC - high
ferritin - low

27
Q

iron, TIBC and ferritin in anaemia of chronic disease

A

iron - low
TIBC - low
ferritin - high

28
Q

iron, TIBC and ferritin in chronic haemolysis

A

iron - high
TIBC - low
ferritin - high

29
Q

iron, TIBC and ferritin in haemochromatosis

A

iron - high
TIBC - low/normal
ferritin - high

30
Q

iron, TIBC and ferritin in pregnancy

A

iron - high
TIBC - high
ferritin - normal

31
Q

iron, TIBC and ferritin in sideroblastic anaemia

A

iron - high
TIBC - normal
ferritin - high

32
Q

transferrin saturation

A

serum Fe/TIBC

<20% indicated iron deficiency

33
Q

when checking ferritin also check

A

CRP

ferritin is acute phase protein increased with inflammation

34
Q

investigations for pancytopenia

A 
B12/folate/iron
abdominal examination
reticulocyte count
blood film
myeloma screen
parvovirus PCR in immunosuppressed
medication review
bone marrow biopsy
35
Q

low reticulocyte suggests

A

bone marrow failure syndromes

36
Q

pancytopenia blood smear

A

look for:
blasts
hairy cell leukaemia features
dysplastic changes - myelodysplasia

Year 5 path (16 decks)

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