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ELM2 - blood > lecture 2 - overview of anaemias > Flashcards

lecture 2 - overview of anaemias Flashcards

1
Q

What factors are considered when determining normal Hb concentration of an individual?

A

age, sex, physiological state (e.g. preganancy), altitude

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2
Q

What are the patient symptoms of anaemia?

A

weakness, fatigue, heart palpitations, pallor, feeling cold

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3
Q

What are the signs of anaemia upon clinical examination?

A

pallor, increased pulse rate, heart failure (severe anaemia)

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4
Q

What is an aetiological classification?

A

A way to classify a condition based on its causes

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5
Q

What are the 2 main aetiological causes of anaemia?

A

Increased blood loss or destruction, impaired red cell production

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6
Q

What is haemolysis?

A

RBC breakdown

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7
Q

What are the 2 types of haemolysis?

A

Inherited, acquired

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8
Q

What are the 3 groups of inherited haemolysis?

A

cell membrane, cell enzymes, Hb abnormalities

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9
Q

What are the causes of acquired haemolysis?

A

antibodies, chemical damage, drugs, parasites, etc.

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10
Q

What are some of the causes of the impairment of RBC production due to erythrocyte maturation disturbance?

A

deficiencies (iron, folate, vitamin B12, etc.), globin gene abnormalities, bone marrow stem cell disturbance

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11
Q

What morphology are the RBCs observed in iron deficiency?

A

microcytic

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12
Q

What morphology are the RBCs observed in thalassaemias?

A

microcytic

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13
Q

What morphology are the RBCs observed in renal disease?

A

normocytic

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14
Q

What morphology are the RBCs generally observed in cancer?

A

normocytic

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15
Q

What morphology are the RBCs observed in megaloblastic anaemia?

A

macrocytic

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16
Q

What morphology are the RBCs observed in liver disease/alcoholism?

A

macrocytic

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17
Q

What morphology are the RBCs observed in myelodysplasia (bone marrow cancer)?

A

macrocytic

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18
Q

What morphology are the RBCs observed in anaemia of inflammation?

A

tend to be microcytic, can be normocytic

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19
Q

What is erythroid hypoplasia?

A

The bone marrow fails to produce sufficient erythrocytes, often due to reduced EPO

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20
Q

What are the components of Haem?

A

Iron, protoporphyrin

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21
Q

What does iron combine with to form Haem?

A

protoporphyrin

22
Q

What is the structure of haemoglobin?

A

Haem + 2 alpha globin peptides + 2 beta globin peptides

23
Q

Why does iron deficiency cause microcytic anaemia?

A

Body is unable to make normal amounts of Hb, meaning the red cells have reduced Hb and are smaller

24
Q

Why do thalassaemias cause microcytic anaemia?

A

reduced production of alpha or beta porteins means Hb production is low and cells contain small amount.

25
Q

Why does inflammation cause microcytic anaemia?

A

Iron is unavailable, so Hb production is low, leading to small red cells

26
Q

What is the appearance of RBCs in someone with iron deficiency?

A

microcytic, hypochromic (pale)

27
Q

What type of macrocytic anaemia is caused by folic acid or vitamin b12 deficiency?

A

Magaloblastic anaemia

28
Q

Why does folic acid or vitamin B12 deficiency lead to macrocytic anaemia?

A

They are needed for nucleic acid synthesis, meaning their absence causes delayed and abnormal maturation in the marrow.

29
Q

What are the main causes of non-megaloblastic macrocytic anaemia?

A

liver disease, increased immature red cell production

30
Q

Why does renal failure cause normocytic anaemia?

A

Lack of EPO production slows RBC production

31
Q

Why can blood loss result in anaemia?

A

Reduced blood volume means that the kidneys retain salt and water to restore volume, diluting the blood before the RBC concentration can be restored.

32
Q

What is the cause of lack of iron availability during inflammation?

A

Liver releases hepcidin peptide which prevents release of iron from stores in the liver, macrophages and spleen.

33
Q

Why does iron therpay not resolve anaemia of inflammation?

A

The body has sufficient iron, but is retaining it in iron stores, and reduced digestive absorption of iron

34
Q

Where are iron stores held during anaemia of inflammation?

A

Macrophages

35
Q

What is the minor cause of anaemia in inflammation, aside from iron sequestration?

A

Reduced response to EPO

36
Q

Where is CRP produced?

A

The liver

37
Q

What does CRP stand for?

A

C-reactive protein

38
Q

What is CRP produced in response to?

A

acute and chronic inflammation

39
Q

What are red cell rouleaux?

A

Stacks or aggregations of RBCs in the blood

40
Q

Why do red cells tend to seperate in normal blood?

A

They have a strong negative electrical charge on their surface

41
Q

Why does inflammation cause red cell rouleaux?

A

Increased concentation of positively charged proteins in the blood neutralises the repelling negative charges of RBCs, causing them to stack together.

42
Q

What are the main globulin proteins that cause red cell rouleaux?

A

immunoglobulins (antibodies), fibrinogen (clotting factor)

43
Q

What is the treatment for anaemia of renal disease?

A

Subcutaneous injection of EPO (erythropoietin)

44
Q

What are the 2 main causes of anaemia due to renal disease?

A

Mainly due to reduced EPO production in the kidneys, some built up waste products shorten red cell survival

45
Q

What cell type is present in unusually high concentrations in the blood in haemolytic anaemia?

A

Reticulocytes (immature RBCs)

46
Q

What are reticulocytes?

A

Immature red blood cells

47
Q

What is the morphology of blood cells in haemolytic anaemia?

A

Contain many reticulocytes - much larger than mature RBCs and have RNA and remnants of cell organelles that appear in stained slides.

48
Q

What chemical is present in high concentrations in the blood in haemolytic anaemia?

A

Bilirubin

49
Q

What is bilirubin?

A

A breakdown product of RBC/haem recycling

50
Q

What protein has very low levels in the blood in haemolytic anaemia, and why?

A

Haptoglobin - us used to mop up Hb from old red cells, so rapidly gets used up when haemolysis is occurring.

ELM2 - blood (14 decks)

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