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HYMS Y4 > KEY ANAEMIA > Flashcards

KEY ANAEMIA Flashcards

1
Q

Define anaemia.

A

Hb level 2 standard deviations below the normal range for age and sex.

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2
Q

Normal Hb range for men.

A

130-180.

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3
Q

Normal Hb range for women.

A

115-165.

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4
Q

5 causes of microcytic anaemia.

A 
IDA
Anaemia of chronic disease
Thalassemia
Sideroblastic anaemia
Lead poisoning
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5
Q

5 causes of normocytic anaemia.

A 
Haemorrhage
Haemolytic anaemias
Leukaemia
Pure red cell aplasia
Aplastic anaemia
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6
Q

6 causes of macrocytic anaemia.

A 
B12/ folate deficiency.
Pregnancy
Chronic alcohol misuse
Drug induced (methotrexate)
Hypothyroidism
Myelodysplastic syndromes
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7
Q

MCV for microcytic anaemia?

A

<80

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8
Q

MCV for normocytic anaemia?

A

80-100

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9
Q

MCV for macrocytic anaemia?

A

> 100

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10
Q

How are microcytic anaemias further classified?

A

Iron studies.

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11
Q

How are normocytic anaemias further classified?

A

Reticulocyte count.

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12
Q

How are macrocytic anaemias further classified?

A

Megaloblastic vs. non-megaloblastic.

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13
Q

What can a mixed iron + B12/folate deficiency cause?

A

A normocytic anaemia (look at RDW to detect).

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14
Q

Iron studies in iron deficiency anaemia?

A

Low serum iron
Low ferritin
High transferrin/ TIBC

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15
Q

Iron studies in anaemia of chronic disease?

A

Low/ normal serum iron
Low/ normal ferritin
Low transferrin/ TIBC

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16
Q

Test used to detect Thalassemia?

A

Mentzer index (MCV/RBC)

<13 = Thalassemia

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17
Q

Causes of normocytic anaemia with <2% reticulocytes.

A

<2% reticulocytes = hypoproliferative:

Leukaemias
Aplastic anaemia
Pure red cell aplasia

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18
Q

Causes of normocytic anaemia with >2% reticulocytes.

A

> 2% reticulocytes = hyper proliferative:

Haemolytic anaemias
Haemorrhage

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19
Q

What does megaloblastic mean?

A

Presence of megalocytes with hyperhsegmented neutrophils.

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20
Q

Causes of megaloblastic macrocytic anaemia.

A

B12 deficiency
Folate deficiency
Drug-induced (methotrexate)

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21
Q

Causes of non-megaloblastic microcytic anaemia.

A

Alcohol abuse
Hypothyroidism
Pregnancy
Myelodysplastic syndromes

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22
Q

Where is iron absorbed?

A

Duodenum

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23
Q

How does iron travel in the blood?

A

Bound to transferrin.

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24
Q

How is iron stored in the blood?

A

By ferritin.

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25
Q

Iron studies in sideroblastic anaemia?

A

High iron
High ferritin
Low transferrin/ TIBC.

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26
Q

4 main categories of cause for iron deficiency anaemia.

A

Decreased intake
Decreased absorption
Increased loss
Increased demand

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27
Q

Why is it common to get a macrocytic anaemia a couple of days after a GI bleed or traumatic bleed?

A

Because bone marrow responds by producing large numbers of reticulocytes.

28
Q

Drugs which can cause macrocytic megaloblastic anaemia.

A

Methotrexate
Azathioprine
Trimethoprim
Phenytoin

29
Q

Why does B12 deficiency need to be corrected before folate deficiency?

A

Giving folate first can cause subacute degeneration of the cord.

30
Q

Where is B12 absorbed?

A

Terminal ileum.

31
Q

Where is Folate absorbed?

A

Jejunum

32
Q

Food substances containing B12?

A

Meat and dairy.

33
Q

Food substances containing folate?

A

Green, leafy vegetables

34
Q

Beta thalassemia inheritance pattern?

A

Autosomal recessive.§

35
Q

When does Beta Thalassemia present?

A

Childhood.

36
Q

Blood film finding in sideroblastic anaemia?

A

Ringed sideroblasts (Iron-engorged peri-nuclear mitochondria in developing RBCs).

37
Q

5 causes of B12 deficiency?

A 
Pernicious anaemia
IBD
Gastric bypass/ gastrectomy
Poor dietary intake
Veganism
38
Q

5 causes of folate deficiency?

A 
Elderly
Alcohol dependent
Haemolysis
Pregnancy
Malabsorption
Anti-folate drugs (methotrexate)
39
Q

The only anaemia to cause neurological symptoms?

A

B12 deficiency

40
Q

Neurological symptoms of B12 deficiency?

A

Confusion
Drowsiness
Poor concentration
Poor memory

41
Q

Patients with pernicious are at an increased risk of what?

A

Gastric cancer

42
Q

Pathognomonic blood findings in pernicious anaemia?

A

Increased IgA antibodies against intrinsic factor/ parietal cells

43
Q

2 categories of haemolytic anaemia?

A

INTRAVASCULAR: RBCs broken down in blood vessels.

EXTRAVASCULAR: RBCs broken down in spleen (more common)

44
Q

3 categories of congenital causes of haemolytic anaemia?

A

Membrane abnormalities
Metabolic machinery abnormalities
Haemoglobin molecule abnormalities

45
Q

2 forms of acquired haemolytic anaemia?

A

Cold autoimmune haemolytic anaemia

Warm autoimmune haemolytic anaemia.

46
Q

Main cause of haemolytic anaemia caused by membrane abnormalities?

A

Hereditary spherocytosis.

47
Q

Findings in hereditary spherocytosis?

A

Circular cells
Low Hb
Raised reticulocytes

48
Q

Main cause of haemolytic anaemia resulting due to a metabolic machinery abnormality?

A

G6PD deficiency.

49
Q

Inheritance pattern of G6PD deficiency?

A

X-linked recessive.

50
Q

Pathognomonic blood film finding in G6PD deficiency?

A

Heinz bodies.

51
Q

2 forms of haemolytic anaemia that affect the haemoglobin molecule?

A

SCD

Thalassemia

52
Q

Difference between warm and cold AIHA?

A

Warm occurs at body temperature

Cold occurs in the peripheries at lower temperatures

53
Q

3 conditions warm AIHA is associated with?

A

CLL
Lymphoma
SLE

54
Q

Warm AIHA is mainly caused by which antibodies?

A

IgG.

55
Q

3 conditions cold AIHA is associated with?

A

Mycoplasma pneumonia
Infectious mononucleosis
Lymphomas

56
Q

Cold AIHA is mainly caused by which antibodies?

A

IgM

57
Q

Non-immune causes of acquired haemolytic anaemia?

A

Mechanical trauma
Infections
Hypersplenism

58
Q

Urinary finding in those with haemolytic anaemia?

A

Haemosiderinuria

59
Q

Test for autoimmune haemolytic anaemia?

A

Direct Coombs test

60
Q

How is acute chest syndrome in those with SCA diagnosed?

A

Fever or respiratory symptoms + presence of infiltrates on XR.

61
Q

Most common cause of osteomyelitis in those with SCA?

A

Salmonella.

62
Q

Classic triad of haemochromatosis?

A

DM
Bronze skin
Hepatomegaly

63
Q

Management for haemochromatosis?

A

Venesection

64
Q

Prophylaxis for what condition can trigger haemolytic anaemia in those with G6PD deficiency?

A

Malaria.

65
Q

RBC transfusion cut off in anaemia?

A

<60

66
Q

RBC transfusion cut off in those who are anaemic with an ACS?

A

<80

HYMS Y4 (8 decks)

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