L03-Anaemia

Question 1

How is anaemia defined?

Answer 1

Defined as a reduction in haemoglobin concentration

Question 2

What are the typical values that haemoglobin must fall below to be classified as anaemic in males and females?

Answer 2

less than 13.5g/dl in males

less than 11.5g/dl in females

Question 3

What are the clinical signs and symptoms of anaemia?

Answer 3

Signs
Pallor of mucous membranes
Angular stomatitis
Koilonychia (spooning of nails)

Symptoms
Tiredness
shortness of breath
palpitations
headache
drowsiness

Question 4

What are the two main ways in which anaemias are classified?

Answer 4

Based on the mean cell volume of the red cells (macro,micro and normocytic)
Based on the cause of the anaemia (loss of production, function or increased destruction of red cells)

Question 5

What are the main causes of macrocytic anaemia?

Answer 5

B12 and folate deficiency
Alcoholism and liver disease
Impaired red cell production
Haemolytic anaemias

Question 6

What is aplastic anaemia?

Answer 6

When a reduction in the number of pluripotent stem cells in the bone marrow causes anaemia through reduction in all the major cell lines: red cells, white cells and platelets

Question 7

What is pernicious anaemia?

Answer 7

This results from an autoimmune attack on the parietal cells of the stomach. This results in a lack of production of intrinsic factors which is essential for vitamin B12 absorption. Vitamin B12 is required for normal haematopoesis and without it abnormally large red cells are produced. This can result in a macrocytic anaemia.
It can also result from an autoimmune attack on the intrinsic factor or the intrinsic factor receptors in the small intestine.

Question 8

What is iron deficiency anaemia?

Answer 8

A lack or intake, increased loss or increased demand of iron which results in not enough iron being present for normal erythropoesis. This results in microcytic anaemia.

Question 9

Why are haemolytic anaemias macrocytic?

Answer 9

They usually have a reticulocyte count as red cells are being moved into the blood from the bone marrow to try and make up for the ones being destoryed. As reticulocytes have a larger mean corpuscular volume than red blood cell this causes a macrocytic anaemia.

Question 10

What are the main causes of normocytic anaemia?

Answer 10

Anaemia of chronic disease-Increased inflammatory IL-6 causes reduced ferroportin so iron is not as available to the bone marrow.
Acute blood loss
Bone marrow failure

Question 11

What are the main causes of microcytic anaemia?

Answer 11

Iron deficiency
Thalassemia - hereditary, results in abnormal haemoglobin production
Sickle cell disease
Sideroblastic anaemia - marrow produces ringed sideroblasts instead of healthy red cells