L6-7 Classfication & Laboratory Diagnosis of Anaemia Flashcards
What are the four main causes for anaemia?
Decrease in production
Increase in Haemolysis
Hypersplenism
Dilution
What are the differential diagnosis when the patient has a decrease in production?
Aplastic anemia or marrow infiltrative lesions
Derease in erythropoietin (chronic renal disease)
Iron deficiency
Thalamssemia
Folic acid deficiency
Myelodysplastic syndrome
What are the cause for hemolysis?
Intracorpuscular: Haemoglobinopathy, red cell enzymopathy, membrane abnormality
Extracorpuscular: alloimmune, autoimmune , drug induced, infeciton, mechanical, burn and toxin
What are the causes for hypersplenism?
Portal hypertension
Haemolytic disease
Chronic infection
Storage disease
What are the cause for dilutional anaemia?
Preognancy
Blood loss + fluid resuscitation
What are the clinical manifestation of anaemia?
Reduced amount of haemoglobin in blood - pallor
Tissue hypoxia - easy fatiuge
Cardiopulmonary compensation - palpitation, dyspnea
What is the most common cause of iron deficiency anaemia?
Blood loss
bleeding from peptic ulcer or carcinoma of colon
What are the clinical symptoms of iron deficiency anaemia?
no symptoms
general symptoms and signs of anaemia
Epithelial changes (glossitis, angular stomatitis, brittle naisl and dysphagia)
Pica
What are the biochemical finding in iron deficiency anaemia?
Low serum iron and low ferritin level
High serum transferrin but low transferrin saturation
What is the haemoatological findings in iron deficiency anaemia?
hypochromic microcytic red cells with anisopoikilocytes
Bone marrow: poorly haemoglobinised
Decrease or absent marrow iron store
Give some examples of vitamin B12 rich food
fish, liver and dairy products
Describe the uptake of vitamin B12
It binds with intrinsic factors secreted by parietal cells and enter the terminal ileum where it binds with transcobalamine
How is vitamin B12 relate to folate?
Vitamin B12 is needed to convert metyhl THF that enters the cell from plasma to THF, from which polyglutamate forms of folate are syntesised.
What are the cause for vitamin B12 deficiency
Dietary insufficiency
Gastric cause- prenicious anaemia, post- gastroectomy
Intestinal causes - Stagnant loop syndrome, malabsorption syndrome, fish tapeworm
Give a brief outline of prenicious anaemia
Antibodies against gastric parietal cells
Loss f parietal cells and intrinsic factors needed for vitamin B12 absorption
