ID Anaemia Flashcards
When you get an anaemic patient, what should you check?
Mean cell volume
haemoglobin and mean cell volume ranges - female
120-165 gram/litre
80-100 femtolites
haemoglobin and mean cell volume ranges - male
130-180 grams/ litre
80-100 femtolites
what are the 3 different types of anaemia?
microcytic - low MCV- small RBC’s
normocytic- normal MCV - normal RBC’s
macrocytic - large MCV - large RBC’s
Microcytic anaemic causes (TAILS)
- Thalassemia
- Anaemia of chronic disease
- Iron deficiency
- Lead poisoning
- Sideroblastic
Nonocytic anaemia causes (3A’S and 2H’s)
- Acute blood loss
- Anaemia of chronic disease
- Aplastic
- Haemolytic
- Hypothyroid
macrolytic - Megaloblastic is caused by?
- impaired DNA synthesis
- vit deficiency = B12 and folate
normoblastic anaemia is caused by?
- what drug can cause it?
- Alcohol
- Reticulocytosis (haemolytic anaemia or blood loss)
- hypothyroidism
- liver diease
AZATHIOPRINE
Symptoms of anaemia
tiredness SOB headaches dizziness palpitations worsening of angina, HF or peripheral VD
what symptoms are specific to Iron deficiency anaemia
pica - craving abnormal foods, eg dirt
hair loss - iron deficiency
What are some generic clinical signs of anaemia?
pale skin
conjunctival pallor
tachycardia
raised RR
What specific signs show clinical iron deficiency ? (4)
koilonychia
angular chelitis/stomatitis
atrophic glossits -smooth tongue
brittle hair
What specific signs show clinical haemolytic anaemia?
jaundice
What specific signs show clinical Thalassaemia
bone deformities
what clinical signs on the skin can indicate chronic kidney disease?
oedema , hypertension and excoriations
investigating anemia?
haemoglobin MCV b12 folate ferritin blood film
Further investigations of unexplained iron deficiency anaemia?
other anaemia types?
OGD and colonoscopy - GI cause
bone marrow biopsy
how can a patient become iron deficient (4)
- dietary
- iron requirement increase (pregnancy)
- iron being lost (GI cancer etc)
- inadequate absorption
where is iron mainly absorbed?
duodenum and jejunum
what medications can cause iron deficiency and how ?
proton pump inhibitors (lansoprazole and omeprazole) - they reduce stomach acid
- high stomach acid is required to change iron into the insoluble form (FE3)
Most common cause of iron deficiency anaemia in adults?
children?
blood loss
dietary deficiency
iron deficiency in females can be a result of ?
what are the most common causes of GI tract bleed ?
what should also be considered?
menorrhagia
oesophagitis, gastritis
IBD, chron’s, ulcerative colitis
how do you calculate the transferrin saturation?
serum iron / total iron binding capacity
when is extra ferritin released?
inflammation (infection or cancer)
what is the best marker for much much transferrin is in the blood?
TIBC
do TIBC and transferrin increase or decrease with iron deficiency and overload?
deficiency - increase
overload - decrease
normal range for transferrin saturation
15-50%
normal range for serum ferritin
41-100ug/l
normal range for serum iron
12-30 ug/l
fastest and most invasive way to treat?
blood infusion
when should iron infusion (cosmofer) not be used?
during sepsis
- small anaphylaxis risk
what oral iron is given and what is the dose?
ferrous sulphate - 200mg 3 times daily
- constipation and dark stool
when correcting IDA with iron, how much can you expect the haemoglobin to rise weekly?
10 grams/litre
