Lecture 4 Red Cells 2 Acquired Anaemias

Question 1

Name the common clinical features of anaemia

Answer 1

Tiredness/Pallor
Breathlessness
Swelling of ankles
Dizziness
Chest pain

Question 2

Serum ferritin is related to what type of anaemia

Answer 2

Hypochromic

Microcytic

Question 3

Low serum ferritin would suggest what type of anaemia

Answer 3

Iron deficiency

Question 4

Normal or increased serum ferritin would suggest what type of anaemia

Answer 4

Thalassaemia
Secondary Anaemia (Sideroblastic)

Question 5

What is the approximate total body iron

Answer 5

4g

Question 6

How is iron bound to the mucosal surface during gut absorption

Answer 6

Ferritin

Question 7

How is iron transported across the basement membrane

Answer 7

Ferroprotein

Question 8

Iron is transported in the plasma bound to what

Answer 8

Transferrin

Question 9

Iron is stored in cells as____

Answer 9

Ferritin

Question 10

Name 5 clinical signs and symptoms of Iron deficiency anaemia

Answer 10

Hypochromic microcytic red ells
Koilonychia
Atrophic tongue
Angular chelitis

Question 11

What is the management of Iron deficiency anaemia

Answer 11

Oral iron
IV if intolerant to oral
Diet
Correct the cause

Question 12

In Normochromic Normocytic Anaemia an increased reticulocyte count would suggest what (2)

Answer 12

Acute blood loss

Haemolysis

Question 13

In Normochromic Normocytic Anaemia a reduced or normal reticulocyte count would suggest what (2)

Answer 13

Secondary anaemia:
Hypoplasia
Marrow infiltration

Question 14

What is the function of Hepcidin

Answer 14

Synthesised in response to high iron levels and inflammation. Block Ferroportin and reduced intestinal absorption

Question 15

Name 2 types of congenital haemolytic anaemias

Answer 15

G6DP deficiency

Hereditary spherocytosis

Question 16

Name 3 causes of acquired hameolytic anaemia

Answer 16

Auto-immune haemolytic anaemia (extravascular)
Severe infection/DIC (Intravascular)
Mechanical e.g. artificial valve

Question 17

Immune mediated acquired anaemia is mostly intra or extravascular

Answer 17

Extravascular

Question 18

In immune mediated haemolytic anaemia the direct antiglobulin test would be positive or negative

Answer 18

Positive

Question 19

Name causes of warm auto-antibody immune haemolysis

Answer 19

Auto-immune
Drugs
CLL

Question 20

Name causes of cold auto-antibody immune haemolysis

Answer 20

CHAD

Infections\Lymphoma

Question 21

Name causes of alloantibody immune haemolysis

Answer 21

Transfusion reaction

Question 22

What type of anaemia is B12 and Folate deficiency

Answer 22

Megaloblastic

Question 23

What is the purpose of Vitamin B12

Answer 23

Binds to intrinsic factor

Question 24

What are the causes of B12 deficiency

Answer 24

Pernicious anaemia

Gastric/ileal disease

Question 25

What are the causes of folate deficiency (3)

Answer 25

Diet
Haemolysis
Coeliac disease

Question 26

What is Pernicious Anaemia

Answer 26

Antibodies against IF and gastric parietal cells

Question 27

How is Pernicious Anaemia diagnosed

Answer 27

Antibodies against IF and gastric parietel cells, Schilling Test

Question 28

How is B12 deficiency treated

Answer 28

B12 intramuscular injection

3 monthly maintenance

Question 29

How is Folate deficiency treated

Answer 29

Oral folate replacement

Question 30

Name other causes of Macrocytosis

Answer 30

Alcohol
Drugs (methotrexate, antivirals, hydroxycarbamide), disordered liver function, hypothyroidism, Myelodysplsia