Introduction to Anaemia

Question 1

What is the definition of Anaemia?

Answer 1

Low total red cell mass

Question 2

How can anaemia be measured?

Answer 2

Haemoglobin

Haematocrit

Question 3

How is Hb measured? (Not sure if important?)

Answer 3

Burst the red cells so Hb in solution
Stabilise Hb molecules
Measure optical density at 540nm
OD is proportional to concentration

Question 4

How is Haematocrit measured?

Answer 4

Ratio of whole blood that is red cells if sample is left to settle?

Question 5

When are Hb and Hct not sufficient?

Answer 5

Rapid bleed of 50% of blood volume

Plasma expansion

Question 6

What is the natural body response to anaemia?

Answer 6

Increased red cell (reticulocyte) production

Question 7

What are reticulocytes?

Answer 7

Red cells that have just left the marrow

Bigger than erythrocytes

Question 8

What other blood tests can be done for anaemia?

Answer 8

FBC
Blood film
Reticulocyte count

Question 9

How can someone become anaemic?

Answer 9

Decreased production
- Hypoproliferative
- Maturation abnormality
Increased loss or destruction
- Bleeding
-Haemolysis

Question 10

What are the 2 practical types of anaemia based on MCV?

Answer 10

Macrocytic (Increased MCV)

MIcrocytic (Decreased MCV)

Question 11

What is macrocytic anaemia suggestive of?

Answer 11

Maturation problem

Question 12

What is microcytic anaemia suggestive of?

Answer 12

Haemoglobin problem

Question 13

What is haemoglobin made from?

Answer 13

Globins
Haem
-Iron (Fe2+)
Porphyrin ring

Question 14

What happens when there is a shortage of HB?

Answer 14

Microcytic and hypochromatic (pale) cells

Question 15

What can cause a Hb shortage?

Answer 15

Haem deficiency
- Iron deficiency
-Chronic disease
Problems with porphyrin synthesis
- Lead poisoning
Globin deficiency
-Thalassaemia

Question 16

What are the 2 types of iron ions?

Answer 16

Fe2+

Fe3+

Question 17

Which iron ion can carry O2?

Answer 17

Fe2+

Question 18

What is iron essential for?

Answer 18

O2 transport
Electron transport
-ATP production

Question 19

What is the iron in circulation bound to?

Answer 19

Transferrin (Cause its transferrin’ the iron about)

Question 20

How is iron tranferred into bone marrow?

Answer 20

By macophages

Question 21

Where is iron stored and how?

Answer 21

In the liver as ferritin

Question 22

How can functional iron be measured?

Answer 22

HB

Question 23

How can transported iron be measured?

Answer 23

Serum iron

Transferrin

Question 24

How can iron stores be measured?

Answer 24

Serum ferritin

Question 25

How many iron molecules can bind to transferrin?

Answer 25

2

Question 26

What happens to transferrin saturation in iron deficiency?

Answer 26

Decreases

Question 27

What happens to transferrin saturation in anaemia of chronic disease?

Answer 27

Decreases

Question 28

What happens to transferrin saturation in haemochromatosis?

Answer 28

Increases

Question 29

What is ferritin?

Answer 29

large intracellular protein

Question 30

When is ferritin decreased?

Answer 30

Iron deficiency

Question 31

What are causes of iron deficiency?

Answer 31

Vegetarian diet Blood loss Malabsorption (coeliac disease)

Question 32

What are some causes of chronic blood loss?

Answer 32

``` Menorrhagia GI -tumours -ulcers -NSAIDs Haematuria ```

Question 33

What is classed as mennorhagia and how much iron is lost?

Answer 33

>60ml/month | >30mg iron/month

Question 34

What does iron deficiency result in?

Answer 34

``` Exhaustion of iron stores Iron deficient erythropoiesis Decreased Red cell volume Microcytic anaemia Epithelial changes ```

Question 35

How is iron absorption increased?

Answer 35

Iron supplements