Haematology - Microcytic Anaemia

Question 1

Definition

Answer 1

Low MCV
Low HB

Question 2

Haemoglobin ranges

Answer 2

Birth = 150-235 grams/litres
2-4 weeks = 135-190 grams/litre
4-8 weeks = 95-130 grams/litre
2 months - 6 years - 110 - 140 grams/litre
6 -12 years - 115 -155 grams/litre
Female 12-18 years = 120 -150 grams/litre
Male 12 - 18 = 130 - 160 grams/litre

Question 3

Aetiology

Answer 3

Physiological anaemia of infancy - v.common
- normal dip in Hb around 6-9 weeks of age
- high O2 delivery to tissue caused by high Hb at birth causes negative feedback where EPO (by kidney) is supressed and reduces production of Hb in bone marrow
TAILS
- Thalassaemia
- Anaemia of chronic disease
- Iron deficiency anaemia
- Lead poisoning
- Sideroblastic anaemia

Question 4

Symptoms

Answer 4

Tiredness
SOB
Headaches
Dizziness
Palpitations
Worsening of other conditons
Iron deficiency
- Pica
- Hairloss

Question 5

Signs

Answer 5

Pale skin
Conjunctival pallor
Tachycardic, raised RR
Koilonychia
Bone deformities - thalassemia
IRON DEFICIENCY:
Angular chelitis
Atrophic glossitis
Brittle hair and nails

Question 6

Investigations

Answer 6

FBC - haemoglobin and MCV
Blood film
Reticulocyte count
Ferritin (low iron deficiency)
B12 and folate
Bilirubin (raised in haemolysis)
Direct Coombs test (autoimmune haemolytic anaemia)
Haemoglobin electrophoresis (haemoglobinopathies)

Question 7

Treatment

Answer 7

Depends on underlying causes
Iron deficiency -> iron supplements