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IOD > Macrocytic and microcytic anaemia > Flashcards

Macrocytic and microcytic anaemia Flashcards

1
Q

Classification of anaemia

A

macrocytic
normocytic
microcytic

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2
Q

Specific questions to ask in an anaemia hx

A 
diet
periods
blood in stools
pregnancy 
PMH
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3
Q

What is a Full Blood Count?

A

The most common blood test: used to assess number and size of cells found in blood

Often a ‘base line’ or ‘basic’ blood test

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4
Q

What are the causes of a microcytic anaemia

A

iron deficiency
thalassaemia (globin deficiency)
anaemia of chronic disease

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5
Q

What does Hct mean on a FBC

A

%of blood volume as RBC

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6
Q

What is MCH in a FBC

A

Average haemoglobin content of RBC

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7
Q

what 4 things does a blood film of RBCs show us?

A

size
shape
colour
inclusions e.g. howell-jolly bodies, nuclear remnants, malarial parasites, basophilic stippling

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8
Q

What does the reticulocyte count tell us?

A

adds further clue as to failure of production or increased losses

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9
Q

causes of macrocytic anaemia

A 
B12 deficiency
folate deficiency 
myelodysplasia
reticulocytosis 
drug induced
liver disease
myxoedema
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10
Q

causes of macrocytic anaemia

A 
B12 deficiency
folate deficiency 
myelodysplasia
reticulocytosis 
drug induced
liver disease
myxoedema
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11
Q

5 things iron is found/stored as

A 
Fe2+
Fe3+
Hb
Ferritin
Haemosiderin
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12
Q

where are ferritin and haemosiderin found

A

liver
spleen
BM

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13
Q

where are ferritin and haemosiderin found

A

liver
spleen
BM

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14
Q

where is iron absorbed?

A

duodenum

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15
Q

what receptors are used in iron absorption?

A

ferroportin

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16
Q

what is the role of hepcidin?

A

Hepcidin causes ferroportin internalization and degradation, thereby decreasing iron transfer into blood plasma from the duodenum

17
Q

4 tests on an iron study

A

serum Fe
ferritin
transferrin saturation
total iron binding capacity

18
Q

what is ferritin?

A

Primary storage protein & providing reserve, Water soluble

19
Q

what is transferrin saturation

A

Ratio of serum iron and total iron binding capacity – revealing %age of transferrin binding sites that have been occupied by iron

20
Q

what is total iron binding capacity?

A

Measurement of the capacity of transferrin to bind iron

It is an indirect measurement of transferrin – a transport protein that carries iron

21
Q

results of each test in the iron study when the pt has iron deficiency

A

Serum Fe- low (normal)
ferritin- low unless inflammation
transferrin saturation- low
TIBC- high

22
Q

2 broad categories of iron deficiency causes

A

not enough in

too much out

23
Q

2 broad causes of macrocytosis

A

megaloblastic- low retic count

non-megaloblastic

24
Q

2 causes of megaloblastic anaemia

A

vitamin B12/folate deficiency

drug related

25
Q

3 causes of non-megaloblastic anaemia

A 
alcoholism
hypothyroidism
liver disease
myelodysplastic syndromes
reticulocytosis
26
Q

2 smear characteristics of megaloblastic anaemia

A

macroovalocytes and hypersegmented neutrophils

27
Q

role of folate in the body

A

DNA synthesis

28
Q

3 categories and 2 examples of each for folate deficiency

A

increased demand- pregnany/breast feeding, infancy and growth spurts, haemolysis and rapid cell turnover

decreased intake- poor diet, elderly, chronic alcohol intake

decreased absorption- medication e.g. folate antagonists, coeliac, jejunal resection, tropical sprue

29
Q

role of vitamin B12 in the body

A

Essential co-factor for methylation in DNA and cell metabolism

30
Q

cofactor needed for B12 absorption

A

IF

31
Q

where is IF made

A

parietal cells of stomach

32
Q

5 causes of B12 def

A

impaired abs- pernicious anaemia

decreased intake- vegan diet

congenital causes- IF receptor deficiency

increased requirements- HIV, haemolysis, pregnancy

medication- alcohol, PP1, metformin

33
Q

5 clinical consequences of anaemia

A 
Brain: cognition, depression, psychosis
Neurology: 
myelopathy, sensory changes, ataxia, spasticity
(SACDC)
Infertility
Cardiac cardiomyopathy
Tongue: glossitis, taste impairment
Blood: Pancytopenia
34
Q

what is pernicious anaemia?

A

AI

Gastric Parietal cell antibodies
IF antibodies

Lack of IF
Lack of
B12 absorption

IOD (54 decks)

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