Lecture 4 Red Cells 2 Acquired Anaemias Flashcards
Name the common clinical features of anaemia
Tiredness/Pallor Breathlessness Swelling of ankles Dizziness Chest pain
Serum ferritin is related to what type of anaemia
Hypochromic
Microcytic
Low serum ferritin would suggest what type of anaemia
Iron deficiency
Normal or increased serum ferritin would suggest what type of anaemia
Thalassaemia Secondary Anaemia (Sideroblastic)
What is the approximate total body iron
4g
How is iron bound to the mucosal surface during gut absorption
Ferritin
How is iron transported across the basement membrane
Ferroprotein
Iron is transported in the plasma bound to what
Transferrin
Iron is stored in cells as____
Ferritin
Name 5 clinical signs and symptoms of Iron deficiency anaemia
Hypochromic microcytic red ells
Koilonychia
Atrophic tongue
Angular chelitis
What is the management of Iron deficiency anaemia
Oral iron
IV if intolerant to oral
Diet
Correct the cause
In Normochromic Normocytic Anaemia an increased reticulocyte count would suggest what (2)
Acute blood loss
Haemolysis
In Normochromic Normocytic Anaemia a reduced or normal reticulocyte count would suggest what (2)
Secondary anaemia:
Hypoplasia
Marrow infiltration
What is the function of Hepcidin
Synthesised in response to high iron levels and inflammation. Block Ferroportin and reduced intestinal absorption
Name 2 types of congenital haemolytic anaemias
G6DP deficiency
Hereditary spherocytosis
Name 3 causes of acquired hameolytic anaemia
Auto-immune haemolytic anaemia (extravascular)
Severe infection/DIC (Intravascular)
Mechanical e.g. artificial valve
Immune mediated acquired anaemia is mostly intra or extravascular
Extravascular
In immune mediated haemolytic anaemia the direct antiglobulin test would be positive or negative
Positive
Name causes of warm auto-antibody immune haemolysis
Auto-immune
Drugs
CLL
Name causes of cold auto-antibody immune haemolysis
CHAD
Infections\Lymphoma
Name causes of alloantibody immune haemolysis
Transfusion reaction
What type of anaemia is B12 and Folate deficiency
Megaloblastic
What is the purpose of Vitamin B12
Binds to intrinsic factor
What are the causes of B12 deficiency
Pernicious anaemia
Gastric/ileal disease
What are the causes of folate deficiency (3)
Diet
Haemolysis
Coeliac disease
What is Pernicious Anaemia
Antibodies against IF and gastric parietal cells
How is Pernicious Anaemia diagnosed
Antibodies against IF and gastric parietel cells, Schilling Test
How is B12 deficiency treated
B12 intramuscular injection
3 monthly maintenance
How is Folate deficiency treated
Oral folate replacement
Name other causes of Macrocytosis
Alcohol Drugs (methotrexate, antivirals, hydroxycarbamide), disordered liver function, hypothyroidism, Myelodysplsia
