Macrocytic and microcytic anaemia Flashcards
Classification of anaemia
macrocytic
normocytic
microcytic
Specific questions to ask in an anaemia hx
diet periods blood in stools pregnancy PMH
What is a Full Blood Count?
The most common blood test: used to assess number and size of cells found in blood
Often a ‘base line’ or ‘basic’ blood test
What are the causes of a microcytic anaemia
iron deficiency
thalassaemia (globin deficiency)
anaemia of chronic disease
What does Hct mean on a FBC
%of blood volume as RBC
What is MCH in a FBC
Average haemoglobin content of RBC
what 4 things does a blood film of RBCs show us?
size
shape
colour
inclusions e.g. howell-jolly bodies, nuclear remnants, malarial parasites, basophilic stippling
What does the reticulocyte count tell us?
adds further clue as to failure of production or increased losses
causes of macrocytic anaemia
B12 deficiency folate deficiency myelodysplasia reticulocytosis drug induced liver disease myxoedema
causes of macrocytic anaemia
B12 deficiency folate deficiency myelodysplasia reticulocytosis drug induced liver disease myxoedema
5 things iron is found/stored as
Fe2+ Fe3+ Hb Ferritin Haemosiderin
where are ferritin and haemosiderin found
liver
spleen
BM
where are ferritin and haemosiderin found
liver
spleen
BM
where is iron absorbed?
duodenum
what receptors are used in iron absorption?
ferroportin
what is the role of hepcidin?
Hepcidin causes ferroportin internalization and degradation, thereby decreasing iron transfer into blood plasma from the duodenum
4 tests on an iron study
serum Fe
ferritin
transferrin saturation
total iron binding capacity
what is ferritin?
Primary storage protein & providing reserve, Water soluble
what is transferrin saturation
Ratio of serum iron and total iron binding capacity – revealing %age of transferrin binding sites that have been occupied by iron
what is total iron binding capacity?
Measurement of the capacity of transferrin to bind iron
It is an indirect measurement of transferrin – a transport protein that carries iron
results of each test in the iron study when the pt has iron deficiency
Serum Fe- low (normal)
ferritin- low unless inflammation
transferrin saturation- low
TIBC- high
2 broad categories of iron deficiency causes
not enough in
too much out
2 broad causes of macrocytosis
megaloblastic- low retic count
non-megaloblastic
2 causes of megaloblastic anaemia
vitamin B12/folate deficiency
drug related
