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AB 4th Year Gen Med > Haematology - Anaemia > Flashcards

Haematology - Anaemia Flashcards

1
Q

what are the blood features of aplastic anaemia?

A

pancytopenia
no abnormal cells
(hypo cellular marrow)

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2
Q

causes of aplastic anaemia?

A

drugs (chloramphenicol/NSAIDs)
idiopathic
autoimmune disease
viral (post hep)

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3
Q

features of aplastic anaemia?

A 
infections
fatigue
SOB
tachycardia
bruising 
bleeding
pallor
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4
Q

Ix and results in aplastic anaemia?

A

FBC (pancytopenia)
reticulocyte count (low)
bone marrow biopsy (hypocellular)

hepatitis test
LFTs
B12 and folate

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5
Q

Tx for aplastic anaemia?

A

monitor
steroids
immunosuppression

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6
Q

what happens in haemolytic anaemia?

A

increased RBC destruction
exceeds bone marrows capacity for production
premature RBCs released into circulation

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7
Q

what features can be seen in haemolytic anaemia?

A

organomegaly
jaundice
no stool/urine changes

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8
Q

where can red cells be destroyed? what are the consequences of each?

A

extravascular -> taken up by liver/spleen causing organomegaly

intravascular -> destroyed in circulation causing

haemoglobinaemia (Hb in circulation)
haemoglobinuria (pink urine)
haemosiderinuria (coca cola urine)

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9
Q

what location of RBC destruction if more dangerous? why?

A

intravascular

abnormal waste products created

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10
Q

what hereditary conditions can cause haemolytic anaemia?

A

G6PDD
sickle cell
thalassaemias
hereditary spherocytosis

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11
Q

Ix for haemolytic anaemia? results?

A 
Hb (low)
FBC 
reticylocytes (high)
blood film (Heinz bodies, red cell fragments)
Coombs test (+ve suggest immune cause)
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12
Q

Tx for haemolytic anaemia?

A

Tx cause
steroids
plasmaphoresis

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13
Q

what happens in microcytic anaemia?

A

shortage of globins/haem to make up Hb
cells are microcytic and hypochromic
cell does not get bigger

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14
Q

features of microcytic anaemia?

A 
angular stomatitis
koilonychia
pica
fatigue
hair loss
glossitis
restless legs
SOB
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15
Q

causes of iron deficiency anaemia?

A

menorrhagia
veggie
GI blood loss
malabsorption

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16
Q

what happens in anaemia of chronic disease?

A

inflam causes hepcidic to be upregulated

iron doesnt leave macrophages due to this

not enough iron to supply marrow -> microcytic hypochromic anaemia

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17
Q

Ix for iron deficiency anaemia? results?

A

transferrin (circulating iron)
ferritin (stores)
Hb (low)
MCV (low)

18
Q

Ix for anaemia of chronic disease? results?

A

transferring (reduced)
serum iron (low)
ferritin (stores - normal/high)

19
Q

Tx for iron deficiency anaemia?

A

ferrous sulphate
ascorbic acid
RBC transfusion

20
Q

Tx for anaemia of chronic disease?

A

treat condition
transfusion
EPO
ferrous sulphate

21
Q

what happens in macrocytic anaemia?

A

megaloblast is a RBC precursor that hasn’t lost its nucleus and failed to get smaller before release into circulation

22
Q

what are the causes of macrocytic anaemia?

A

megaloblastic = defect in DNA synthesis/nuclear maturation:
B12 deficiency
folate deficiency

non megaloblastic:
alcohol
liver disease
marrow failure

spurious = size of RBC normal but MCV high:
acute blood loss

23
Q

where is folate absorbed?

A

jejunum

24
Q

where is B12 absorbed?

A

terminal ileum while bound to IF (released by parietal cells)

25
Q

what happens in pernicious anaemia?

A

autoantibodies against IF/gastric parietal cells

26
Q

features of macrocytic anaemia?

A 
wt loss
diarrhoea
sore tongue
jaundice 
stomatitis
chelitis
pallor of conjunctiva
27
Q

features of B12 deficiency?

A

dementia
peripheral neuropathy
dorsal column abnormalities

28
Q

what dorsal column abnormalities result in B12 deficiency? why?

A

loss of fine touch, vibration and proprioception

subacute combined degeneration of the cord

29
Q

Ix for macrocytic anaemia? result?

A 
Hb (low)
MCV (high)
blood film (macrovalocytes and hyperseg neutrophils)
B12 and folate
anti gastric parietal cell Ab
anti intrinsic factor Ab
30
Q

Tx for macrocytic anaemia?

A

hydroxycobalamin injections
5mg folic acid
RBC transfusion

31
Q

what is the inheritance of sickle cell?

A

autosomal recessive

32
Q

what is the pathology of sickle cell mutation?

A

HbS is created due to defect in B chains of Hb
made of 2alpha and 2betaS
polymerises in low oxygen

33
Q

what is normal HbA made of?

A

2 alpha

2 beta

34
Q

features of sickle cell? what happens to those with trait?

A

painful
lungs, spleen, digits, bone marrow
hyposplenism

traits only in severe stress/illness

35
Q

Ix for sickle cell?

A

FBC
blood film
HPLC

36
Q

Tx for sickle cell crisis?

A 
opiates
oxygen
hydrate
rest 
transfusion
37
Q

Tx for sickle cell?

A

penicillin vaccination

hydroxycarbamide/hydroxyurea

38
Q

what are acquired IMMUNE causes of haemolytic anaemia?

A

warm/cold

transfusion reactions

39
Q

what are acquired NON IMMUNE causes of haemolytic anaemia?

A

TTP
DIC
prosthetic heart valves
malaria

40
Q

out of warm and cold haemolytic anaemia, where does haemolysis occur?

A

warm - extravascular

cold - intravascular

41
Q

causes of a normocytic anaemia?

A 
CKD
haemolytic anaemias
anaemia of chronic disease
aplastic anaemia
blood loss
42
Q

in chronic alcoholism, what happens to bloods?

A

megaloblastic anaemia (high MCV)
thrombocytopenia
hypoalbuminaemia
hyponatraemia

AB 4th Year Gen Med (27 decks)

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