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Haematology > Macrocytic Anaemia > Flashcards

Macrocytic Anaemia Flashcards

1
Q

What is macrocytic anaemia?

A

Anaemia in which red blood cells have larger volume than normal
High MCV

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2
Q

What is macrocytosis?

A

An increase in MCV

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3
Q

Does macrocytosis have to mean anaemia?

A

No

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4
Q

Causes of macrocytosis?

A

Spurious

Genuine - megaloblastic / non-megaloblastic

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5
Q

What is a megaloblast?

A

An abnormally large nucleated red cell precursor with an immature nucleus

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6
Q

Why is there a larger cell cell in megaloblastic anaemia?

A

Failure of cells to become smaller

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7
Q

Causes of megaloblastic anaemia?

A

B12 deficiency
Folate deficiency
Drugs
Rare inherited abnormalities

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8
Q

What is pernicious anaemia ?

A

An autoimmune condition resulting in destruction of gastric parietal cells
Results in intrinsic factor deficiency and B12 malabsorption and deficiency

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9
Q

Why can people with pernicious anaemia appear jaundiced ?

A

Red cells die prematurely in marrow
Hb and LDH released from red cells
Hb -> bilirubin

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10
Q

Where do we get B12 from ?

A

Meat

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11
Q

Where do we get folate from?

A

Leafy veg and yeast

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12
Q

Causes of folate deficiency?

A

Dietary - inadequate intake
Malabsorption - coeliac, crohns
Excess utilisation - haemolysis, pregnancy, malignancy, exfoliating dermatitis
Drugs - anti-convulsants

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13
Q

Clinical features of B12 / folate deficiency ?

A

Weight loss / diarrhoea / infertility
Sore tongue
Jaundice
Developmental problems

Just B12:
Posterior and dorsal column abnormalities 
Neuropathy
Dementia
Psychiatric manifestations
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14
Q

Treatments of megaloblastic anaemia?

A

Treat cause if possible
Vitamin B12 injections for life if pernicious anaemia
Folic acid tablets orally - 5mg/ day
Only if potentially life threatening - transfuse red cells

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15
Q

Non megaloblastic macrocytosis is due to what?

A

Red cell membrane changes

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16
Q

Causes of non megaloblastic macrocytosis

A 
Alcohol 
Liver disease
Hypothyroidism 
Marrow failure
- myelodysplasia 
- myeloma
- aplastic anaemia
17
Q

What is spurious macrocytosis?

A

When size of mature red cell is normal but MCV is measured as being high

18
Q

Causes of spurious macrocytosis?

A

Increase in reticulocytes numbers as marrow response to haemolysis
Reticulocytes bigger than mature red cells in MCV measurement

Haematology (25 decks)

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