Haematology - Anaemia

Question 1

Blood Film - Anaemia of Chronic Disease

Answer 1

Normocytic, normochromic anaemia

(Microcytic in some cases)

Question 2

Pathophysiology - Anaemia of Chronic Disease

Answer 2

Continuous inflammation due to chronic disease causes impaired iron metabolism = reduced RBC production

Question 3

Presentation - Anaemia of Chronic Disease

Answer 3

Incidental finding
Symptoms of anaemia = SOB, fatigue, pallor

Question 4

Iron Studies Results - Anaemia of Chronic Disease

Answer 4

Serum iron = low
TIBC = low
Transferrin saturation = low
Ferritin = high

Question 5

Management - Anaemia of Chronic Disease

Answer 5

Treat underlying cause

Question 6

Management (Unresponsive/Severe Cases) - Anaemia of Chronic Disease

Answer 6

RBC transfusions
Erythropoesis stimulating agents
Supplemental iron

Question 7

Causes - B12 Deficiency

Answer 7

Absence of dietary B12 (vegan diet)
Drugs e.g. PPIs
Pernicious anaemia

Question 8

Presentation - B12 Deficiency

Answer 8

Diarrhoea
Glossitis
Paraesthesias
Anaemia
Weight loss

Question 9

Type of Anaemia - B12 Deficiency

Answer 9

Megaloblastic anaemia - a type of macrocytosis

Question 10

Blood Results - B12 Deficiency (Anaemia)

Answer 10

FBC = high MCV, low Hb
Serum B12 = low
Blood film = hyperhsegmented neutrophils

Question 11

Management (Symptomatic) - B12 Deficiency

Answer 11

1mg IM tydroxycobalamin 3 times weekly for two weeks, then once every 3 months

Question 12

Management (Asymptomatic) - B12 Deficiency

Answer 12

Dietary supplementation + multi-vitamins
Oral cyanocobalamin

Question 13

Complications - B12 Deficiency

Answer 13

Subacute combined degeneration of the cord

Question 14

Daily requirement of B12 and why?

Answer 14

1.5ug/day

Needed for developmentt of RBCs

Question 15

Site of B12 absorption

Answer 15

Ileum