Macrocytic Anaemia Flashcards

1
Q

define macrocytic anaemia

A

red cells are large

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

two types of macrocytic anaemia

A
  1. genuine (true)

2. spurious (false)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

two types of genuine (true) macrocytic anaemias

A

megaloblastic

non-megaloblastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

causes of megaloblastic anaemia

A

B12 deficiency
folate deficiency
drugs
rare inherited abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

causes of non-megaloblastic macrocytic anaemia

A

alcohol
liver disease
hypothyroidism
marrow failure (myelodysplasia, myeloma or aplastic anaemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

two causes of spurious macrocytic anaemia

A
  1. reticulocytosis

2. agglutination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is reticulocytosis?

A

increased reticulocytes due to marrow response to acute blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

define agglutination

A

cold agglutinins are clumping of red cells at cold temperature and it is seen/ diagnosed as one large cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

define pernicious anaemia

A

AI condition resulting in destruction of gastric parietal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what does pernicious anaemia cause?

A

inability to secrete intrinsic factor leading to deficiency of B12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

associations with pernicious anaemia

A

atrophic gastritis

personal/FH of AI disorders (hypothyroid, vitiligo, Addison’s)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

presentation of B12/folate deficiency

A
anaemia= tiredness, SOB
weight loss, diarrhoea
infertility
glossitis
angular cheilitis
jaundice (pernicious anaemia)
B12 only= neurological
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

why does pernicious anaemia present with jaundice?

A

intramedullary haemolysis

red cells die prematurely releasing Hb and LDH, Hb is converted to bilirubin causing jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

neurological presentations of B12 deficiency

A

dorsal column
neuropathy
dementia
psychiatric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

diagnosis of macrocytic anaemia

A
FBC
blood film
assay of B12 and folate levels
antibodies (pernicious anaemia)
Schilling's for B12
bone marrow
measure metabolites and holotranscobalamin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what does the blood film show in macrocytic anaemia?

A

macrovalocytes

hypersegmented neutrophils

17
Q

antibodies in pernicious anaemia

A

anti-GPC (not specific, but sensitive)

anti-IF (not sensitive but specific)

18
Q

management of B12 deficiency

A

B12 IM injections= 3 times a week for 2 weeks the loading every 2-3 months

if neurological involvement then alternative days til improvement then every 2 months

if life-threatening then blood transfusion

19
Q

management of folate deficiency

A

folic acid tablets

transfusion