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Cardiorespiratory CC > Macrocytic and Haemolytic Anaemia > Flashcards

Macrocytic and Haemolytic Anaemia Flashcards

1
Q

Cobalamin

A

Vit B12

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2
Q

Vit B12

A

Water soluble

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3
Q

Vit B12 function

A

Myelin synthesis in NS

Assists in DNA synthesis

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4
Q

B12 or B9 deficiency

A

Macrocytic anaemia
Red cell >96fl
Increased serum MMA level

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5
Q

Methionine synthase

A

Enzyme
Uses B12 to generate THF and Methionine
THF important in DNA synthesis

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6
Q

THF insufficiency

A

Ineffective production of cells with rapid turnover

In particular RBCs

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7
Q

THF from diet

A

From folate

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8
Q

Vit B12 source diet

A

Meat
eggs
cheese
animal protein

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9
Q

Vit B9 source

A

liver
greens
yeast

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10
Q

Vit B12 storage

A

3 years

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11
Q

Vit B9 storage

A

4 months

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12
Q

Vit B12 absorption

A

Bound to IF

Jejunum

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13
Q

Vit B9 absorption

A

Duodenum + jejunum

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14
Q

Intrinsic Factor Production

A

Parietal cells

Gastric Mucosea

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15
Q

Pernicious anaemia

A

Absence of IF

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16
Q

ileum

A

2-4m long
Follows jejunum
Separated from cecum by ileocecal valve and ileo-cecal junction

17
Q

B12 deficiency causes

A

Nutritional
Malabsorption
– gastric- pernicious anaemia, surgical gastrectomy
– intestinal- ileal disease

18
Q

Pernicious anaemia

A 
Autoimmune
F>M
Nordic look
Autoantibody against parietal cells + IF
Leads to gastric atrophy, decreased acid and decreased IF production
19
Q

Pernicious Anaemia clinical factors

A

Anaemia
Glossitis
Jaundice
Neurological Symptoms

20
Q

Pernicious Anaemia treatment

A

Intramuscular B12 every 3 months for life

21
Q

Folic Acid deficiency causes

A

Nutritional
Malabsorption
Excess utilisation- pregnancy

22
Q

Folic acid deficiency treatment

A

Oral folic acid

23
Q

Haemolytic Anaemia presentation

A

Pallor
Jaundice
Gallstones
Splenomegaly

24
Q

Haemolytic anaemia membrane pathology

A

Hereditary spherocytosis
Oxidising agents
Antibodies against RBC membrane

25
Q

Haemolytic anaemia Haemoglobin pathology

A

Abnormal structure

26
Q

Haemolytic anaemia enzyme pathology

A

Glucose-6-phosphate dehydrogenase def.

27
Q

Red cell breakdown

A

Increased serum unconjugated bilirubin
Increase urinary urobilinogen
Increased lactate dehydrogenase

28
Q

Increased RBC production

A

Increased reticulocytes in blood

Increased RBCs in marrow

29
Q

Hereditary spherocytosis

A

Defect in proteins of RBC cytoskeleton
RBC becomes sphere
Smaller SA
High fragility- prone to physical degradation

30
Q

Hereditary spherocytosis characteristics

A 
autosomal dominant
chronic haemolytic anaemia
lower Hb
higher LDL
higher unconjugated serum bilirubin
31
Q

G6PD deficiency

A

Prevents oxidation of Hb
Prolongs RBC lifetime
X linked

32
Q

G6Pd carriers triggers

A

Fava beans
bacterial / viral infection
drugs

33
Q

Autoimmune haemolytic anaemia

A

IgG antibodies in blood that react with RBC membrane proteins

Cardiorespiratory CC (34 decks)

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