macrocytic anaemia

Question 1

megaloblastic (bone marrow) causes macrocytic anaemia

Answer 1

vit B12 + folate deficiency

Question 2

normoblastic macrocytic anaemia

Answer 2

methotrexate // alcohol + liver disease // hypothyroid // retoculocytosis // myelodysplasia // pregnant

Question 3

blood film megaloblastic anaemia

Answer 3

hypersegmented neutrophils

Question 4

function of B12

Answer 4

red blood cell development + maintenance NS

Question 5

how is B12 absorbed

Answer 5

binds to intrinsic factor in stomach –> terminal ileum

Question 6

causes B 12 def

Answer 6

pernicious anaemia // vegan // crohns // surgery // alcohol // gastritis from H pylori

Question 7

what surgeries can cause B12 def

Answer 7

gastrectomy + ileocaecal resection

Question 8

cymptoms B12 def

Answer 8

macrocytic anemia // sore tongue // neuro symptoms (joint position and vibration –> paraesthesia) // mood changes

Question 9

symptoms pernicous anaemia

Answer 9

tired, pale, SOB // peripheral neuropathy // subacite degen spinal cord // mild jaundice –> lemon tinge // sore tongue // mood

Question 10

symptoms subacute degen spinal cord

Answer 10

weakness // ataxia // paraesthesia

Question 11

what antibodies are formed in pernicious anaemia

Answer 11

antibodies to intrinsic factor

Question 12

how does pernicious anaemia cause anaemia

Answer 12

antibodies to IF –> reduced B12 absorption

Question 13

RF and assocs pernicious anaemia

Answer 13

female // middle ages // thyroid, T1Dm, addisons, rheumatoid, vitilogo // group A blood

Question 14

bloods pernicious anaemia

Answer 14

macrocytic anaemia // hypersegmented neutrophils // anti IF // B12 <200 // (maybe low WCC + platelets)

Question 15

mx B12 def

Answer 15

1mg IM hydroxocobalamin 3x week for 2 weeks –> 1 every 3 months

Question 16

cancer risk from pernicious anaemia

Answer 16

gastric

Question 17

why does B12 need to be treated before folate def

Answer 17

to reduce risk of subacute degeneration of spinal cord

Question 18

causes folate deficiency

Answer 18

phenytoin // methotrexate // pregnancy // alcohol // diet

Question 19

mx folate deficiency

Answer 19

5mg folic acid / day

Question 20

what is spurious anaemia

Answer 20

normal volume of RBC but too big

Question 21

what can cause spurious anaemia

Answer 21

bleeding / haemlysis –> reticulocytosis

Question 22

what is reticulocytsosis

Answer 22

formation of immature RBCs in response to loss of normal RBCs

Question 23

what is cryoglobunimae

Answer 23

cold agglutins (Ig) which clump together at 4 degrees and disolve again at 37C

Question 24

what can cause cryoglobunimae

Answer 24

type I = myleloma or waldernstrom // II = hep C, RA, sjorgens, lymphoma // III = RA or sjorgens

Question 25

symptoms cryoglobunimae

Answer 25

raynauds, purpura, ulcer, arthralgia, glomerlunephrits

Question 26

invx cryoglobunimae

Answer 26

low C4, high ESR

Question 27

mx Cryoglobulinaemia

Answer 27

immunosupression / plasmapheresis

Question 28

what is cold agglutins

Answer 28

antibodies --> cells clump togetehr at cold temp --> blocked vessel

Question 29

what would macrocytic anaemia + raised reticulocytes indicate

Answer 29

haemolysis / haemorrhage

Question 30

what would macrocytic anaemia + normal reticulocytes indicate

Answer 30

blood films --> B12/ folate

Question 31

what characterises aplastic anaemia (normocytic)

Answer 31

hypoplastic bone marrow + panyctopenia

Question 32

bloods aplastic anaemia

Answer 32

normochromic, normocytic anaemia (SOB, pallor) // leukopenia (infections) // thrombocytopenia (bleeding, bruising)

Question 33

causes aplastic anaemia

Answer 33

inherited eg Faconis // meds // infection eg parvivirus // radiation // leukaemia

Question 34

meds that cause aplastic anaemia

Answer 34

cytotoxics // chloramphenicol // sulphonamides // phenytoin

Question 35

inheritence faconi anaemia

Answer 35

recessive

Question 36

features fanconi anaemia

Answer 36

aplastic anaemia // neurological // short stature // cafe au laits // (AML)