Haematology Core Conditions Flashcards
What values define anaemia for:
a) Men
b) Women and children
c) Pregnant women
a) <13g/dL
b) <12g/dL
c) <11g/dL
Relative vs absolute anaemia?
Relative = increased blood volume, normal cells Absolute = cell number reduced
Who gets iron def anaemia?
Premenopausal women with heavy periods
Pregnant women
Causes of IDA?
Excessive blood loss NSAID use GIT carcinoma G or D ulcer Heavy menses Dietary inadequacies (veggie) Failure to absorb Excessive need for iron
Risk factors for IDA?
Female Low birth weight Rapidly growing Vegetarian Frequent blood donor Pregnancy Heavy periods
Symptoms of IDA?
Fatigue Palpitations Headaches/dizzy SOB Angina Intermittent claudication Pallor Tachycardia HF Koilonychia Jaundice (heamolytic anaemia) Bone deformities (major thal) Leg ulcers (sickle cell)
Differentials for IDA?
Hereditary spherocytosis Thalassaemia Sideroblastic anaemias Anaemia of chronic disease Copper def Lead poisoning
Investigations for IDA?
Abdo exam (organomegaly) Bimanual exam + potential cervical smear PR for rectal bleeding/tenesmus FBC, blood ferritin Screen for coeliacs
Treatment for IDA?
200mg ferrous sulphate 2-3 times a day
Eat iron rich foods
Re check iron at 2-4 weeks
Who is primarily affected by macrocytic anaemia?
Women >60
FHx
Autoimmune disease
Causes of B12 deficiency megaloblastic anaemia?
Pernicious anaemia Post surgery (gastrectomy/ileal resection) Bacterial overgrowth Parasitic infection HIV Dietary deficiency
Causes of folate deficient megaloblastic anaemia?
Diet deficiency
Malabsorption
Increased demands
Haemolysis, leukaemia, rapid turnover from skin diseases
Other causes of megaloblastic anaemia?
Increased urinary output
Acute hepatitis
Dialysis
Drug induced deficiencies
Non-megaloblastic anaemia?
Alcohol Reticulocytosis Liver disease Hypothyroidism Pregnancy Myelodysplasia Myeloma Myeloproliferative disorder Aplastic anaemias
Risk factors for macrocytic anaemia?
Poor diet Lack of IF Removal of distal ileum Crohn's Chronic alcoholism Coeliac's Fish tapeworm infection Surgical removal of GIT Antacid use (chronic)
Symptoms of macrocytic anaemia?
Pallor Fatigue Dyspnoea Anorexia Headahce Bowel disturbances Prematurely grey hair Blue eyes Gum hypertrophy Atrophic glossitis Tachycardia Systolic ejection murmur Polyneuropathy with symmetrical paraesthesia Dementia/psych issues Hallucinations/delusions
Differentials for macrocytic anaemia?
Acute myelocytic anaemia Chronic anaemia Bone marrow failure Hypopituitarism Trauma Intestinal protozoal disease Malabsorption Malnutrition Soy intolerance
Investigations for macrocytic anaemia?
FBC, blood film, folate, B12 Schilling test for B12 def LFTs Urinalysis and U+Es, creatinine Coombs to exclude haemolytic anaemia (detects anti RBC Abs)
Treatment for macrocytic anaemia?
Correct deficiency Folic acid (5mg) Treat B12 deficiency first, if you administer folate before B12 is stabilised then you can precipitate subacute combined degeneration of the cord
