Haematology/Lymphatic - Lecture 5 Flashcards
What is anaemia & what causes it?
Signs & symptoms…
MUST KNOW
insufficient red blood cells or haemoglobin
Caused by blood loss, deficient erythropoiesis, excessive haemolysis (breaking open of a red blood cell causing haemoglobin to be released)
Not sensitive or specific but include….
weakness - seeing ‘spots’, fatigue, pallor, drowsiness, angina, syncope, dyspnoea on exertion, vertigo, HA, pulsatile tinnitus, amenorrhea
Blood loss anaemia
decrease in volume of blood plasma (hypovolemia) leads to interstitial fluid diffusing into the intravascular space
Chronic - if the rate of blood cell loss is greater than the ability of the body to replace
when increased erythropoiesis results in depletion of iron stores
Signs - any excessive bleeding
Note - deficient erythropoiesis means iron deficiency anaemia which is the anaemia of chronic disease
Iron deficiency anaemia
iron is poorly absorbed barely meets daily requirements
blood loss is generally the cause or when more iron is generally required such as pregnancy & adolescence
Chronic disease anaemia: eg - infection, inflamm. cancers
why does it arise?
Due to a slightly shortened RBC survival
impaired erythropoiesis
impaired intracellular metabolism
Megaloblastic macrocytic anaemia arises from….
what are the signs?
B12 deficiency and folate deficiency
Signs - B12 low - peripheral neuropathy, dementia
folate low - diarrhoea, tongue inflamm. - glossitis
Signs - stocking glove paraesthesia
Anaemia from excessive haemolysis (premature destruction of RBCs - usually 120 days)
Caused by 2 main conditions -
1 - Intrinsic RBC disorders - sickle cell
2 - Extrinsic to RBCs - immunological, infection, toxins, mechanical trauma
Sign - jaundice & dark urine
Sickle cell - diffuse, severe bone & chest pain
What are the risk factors for anaemia?
vegan diet
alcoholism
some medication makes you prone to haemolysis (destruction of RBCs prematurely)
cancer, rheumatic disorders, chronic inflam - can all lead to suppressing bone marrow activity in the spleen
Polycythemia Vera - what is it? Symptoms…
increased production of RBCs, WBCs and platelets
(spleen, liver may be involved in this increased production)
leads to increased blood volume & viscosity
makes you prone to thrombosis leading to strokes,TIAs, DVT’s, MI, retinal artery/vein occlusion &/or splenal infarction
Often asymptomatic but otherwise…..
weakness, HA, light headedness, visual disturbances, fatigue, dyspnoea
face, plams & feet may be red, warm, painful
hepatomegaly & spleenomegaly
What is haemophilia?
an x-linked inherited disorder, almost exclusively affecting men that impairs the bodies ability to blood clot or coagulate
look out for intra-cranial bleeding with minor force to the head, can easily get haemarthoses (joint bleeding), lower BP - retroperitoneal haemorrhage
Haemochromatosis - what is it & what can it lead to?
excessive iron that can lead to tissue damage
generally needs to be 4-8 times higher to have symptoms
Can lead to - organ damage - signs of fatigue here
liver disease, cardiomyopathy
Initially in men may present as erectile dysfunction, hypogonadism, maybe glucose intolerance/diabetes melltius, hypothyroidism
Lymphadenopathy - what is it & where does it come from?
a palpable enlargement of one or more lymph nodes, greater than 1cm - localised or generalised
can have lymphadenitis
can come from upper resp. infections, local soft tissue infections, cancer, HIV, TB - less than 1% cancer related
Lymphadenopathy red flags
Node > 2 cm Node that is hard or fixed to underlying tissue Supraclavicular node Risk factors for HIV or TB Fever and/or weight loss Splenomegaly
Signs & symptoms of lymphadenopathy
runny congested nose sore throat - pharyngitis mouth, gum, tooth pain fever, fatigue, malaise genital lesions or discharge joint pain, swelling easy bleeding/bruising dry irritated eyes
Most causes are idiopathic, self-limited
What is lymphoedema & what are the 3 stages?
Obstruction or destruction of lymph vessels leading to lymphoedema - often from surgery, radiation therapy, trauma or obstruction by a tumour
1 - oedema is pitting & affected area returns to normal by morning
2 - oedema is non - pitting & chronic soft tissue inflam. causes early fibrosis
3 - oedema is brawny & reversible, largely bc. of soft tissue fibrosis
