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MEH > Haemotology Revision > Flashcards

Haemotology Revision Flashcards

1
Q

How are RBCs removed from circulation for degeneration?

A

By macrophages in the reticuloendothelial system.

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2
Q

What are the classic symptoms of anaemia?

A

Sob, tiredness, palpitations, headache, cardiac failure

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3
Q

What are signs of anaemia?

A

Pallor, tachycardia,tachypnoea, hypotension

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4
Q

What are some of the signs and symptoms specifically associated with the cause of anaemia

A

Iron deficiency = koilonychia and angular stomatitis
Vit B12 deficiency = glossitis
Thalassaemia = abnormal facial development

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5
Q

What is one of the key tests used to differentiate whether an anaemia is caused by inappropriate production or premature destruction?

A

Reticulocyte count

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6
Q

In bone marrow failure problems, what is the reticulocyte count like?

A

Low or inappropriately normal

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7
Q

What are reticulocytes?

A

Precursors or RBCs that are released by the bone marrow into circulation, still containing some RNA.

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8
Q

How do reticulocytes look on a blood film?

A

Stain slightly blue - polychromatic (lots of colours)

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9
Q

What is the MCV?

A

The mean cell volume of erythrocytes. Gives us information on their size - microcytic, normocytic, macrocytic

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10
Q

What are the common causes of macrocytic anaemia with a low reticulocyte count?

A 
Low reticulocyte count so must be causing issues in the bone marrow 
Vitamin B12 deficiency
Folate deficiency 
Myelodysplasia
Liver disease
Hypothyroidism
Alcohol
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11
Q

What conditions can cause a normocytic anaemia with a low reticulocyte count?

A

Low reticulocyte count so must be due to an issue in the bone marrow
Primary bone marrow failure - aplastic anaemia, red cell aplasia
Secondary bone marrow failure - anaemia of chronic disease, combined haematinic deficiencies, uraemia, endocrine abnormalities, HIV infection

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12
Q

What conditions can cause microcytic anaemia with a low reticulocyte count?

A 
TAILS
Thalassaemia trait
Anaemia of chronic disease
Iron deficiency 
Lead poisoning 
Sideroblastic anaemia
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13
Q

What can be used as evidence of haemolysis?

A

Often macrocytic due to high reticulocyte count
High LDH - lactate dehydrogenase is released from lysed RBC
High bilirubin

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14
Q

What are the 3 main types of anaemia?

A

Acute blood loss
Splenic sequestration
Haemolysis

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15
Q

What is the difference between intravascular and extravascular haemolysis?

A

Intravascular haemolysis = RBCs breaking down within the blood vessels
extravascular haemolysis = RBC being coated with antibodies and are removed by the spleen or wider RES

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16
Q

What are the inherited causes of haemolytic anaemia?

A

Glycolysis defact - pyruvate kinase deficiency
Pentose p pathway - G6PDH deficiency
Membrane protein - hereditary spherocytosis
Haemoglobin defect - sickle cell

17
Q

What are the acquired causes of haemolytic anaemia?

A

Mechanical damage - microangiopathic anaemia
Antibody damage - autoimmune haemolytic anaemia
Oxidant damage - exposure to chemicals or oxidants
Heat damage - severe burns
Enzymatic damage - snake venom

18
Q

What are some of the main complications of prolonged haemolytic anaemia?

A

Pigment gallstones

Splenomegaly

19
Q

What can cause mechanical damage to the RBCs?

A

Heart valves
Vasculitis
MAHA
DIC

20
Q

What indication of pathology can be seen on the blood film of a patient with MAHA?

A

Schistiocytes

21
Q

What is thalassaemia?

A

A reduced rate of synthesis of normal alpha or beta globin chains

22
Q

What are the 2 main different types of autoimmune haemolytic anaemias?

A

Warm autoimmune haemolytic anaemia - IgG, maximally active at higher temperatures
Cold autoimmune haemolytic anaemia - IgM, maximally active at a lower temperature

23
Q

What can cause autoimmune haemolytic anaemias?

A

Infections

Cancers of the lymphoid system

24
Q

What is haematocrit?

A

The proportion of blood that is made up of RBCs

25
Q

What is the red cells count?

A

The number of red blood cells in a given volume of blood

26
Q

What is anisocytosis?

A

An increased variation in the size of RBCs

27
Q

Why does vitamin B12 and folate deficiency cause anaemia?

A

As both are important for the production of thymidine, one of the building blocks for DNA. Results in a megolablastic anaemia.

28
Q

What is pernicious anaemia?

A

An autoimmune deficiency affecting the parietal cells causing lack of intrinsic factor. Causes low vitamin B12 and megaloblastic anaeamia

29
Q

What are the peripheral blood film features seen during megaloblastic anaemias?

A 
Macrocytic red cells 
Anisopoikilocytosis with tear drops 
Hypersegmental neutrophils
Pancytopenia 
An see white cells precursors
30
Q

Why should patients that are anaemic due to vitamin B12 deficiency not receive a red cell transfusion?

A

As vitamin B12 deficiency takes a long time to develop.The heart has most likely been compensated and has hypertrophied. Giving units of blood can cause a high output cardiac failure

31
Q

How do we normally treat a vitamin b12 deficiency?

A

Pernicious anaemia = hydroxycobalamin for life

Other cause = oral cyanocobalamine

MEH (23 decks)

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