Mechanisms of anaemia L2

Question 1

Anaemia definition

Answer 1

reduced number of RBC in circulation or decreased haemoglobin

Question 2

What does anaemia result in

Answer 2

reduced levels of oxygen delivery to tissues

Question 3

Signs of anaemia; (5)

Answer 3

pallor
tachycardia (pulse>100 bpm) 
Glossitis
koilonychia 
Dark urine

Question 4

What is koilonychia

Answer 4

spoon nails

Question 5

what is glossitis

Answer 5

swollen and painful tongue

Question 6

Symptoms of anaemia: (4)

Answer 6

fatigue
weakness
dizziness 
palpations 
shortness of breath

Question 7

Erythropoesis=

Answer 7

production of RBC

Question 8

Precursor of RBC

Answer 8

Reticulocyte

Question 9

What is pure red cell aplasia (PRCA)

Answer 9

conditions affecting specifically erythropoiesis in the bone marrow

Question 10

Most common type of pure red cell aplasia

Answer 10

diamond-blackfan anaemia

Question 11

What is Diamond-blackfan anaemia

Answer 11

congenital reduced proliferation of erythroblasts

Question 12

What is aquired (secondary) Pure red cell aplasia

Answer 12

acquired as exposure to pathogenic agents or drug or infection

Question 13

What can cause anaemia through changes in bone marrow

Answer 13

congenital
infections
malignancy
autoimmune disease

Question 14

What do most conditions in the bone marrow cause

Answer 14

pancytopenia and aplastic anaemia in addition to red cell aplasia

Question 15

What is aplastic anaemia

Answer 15

damage of bone marrow and haematopoietic stem cells causing deficiency all all three blood cells

Question 16

Failure of haematopoietic stem cells will lead to

Answer 16

pancytopenia

Question 17

pancytopenia=

Answer 17

deficiency of all three cellular components of blood

not a diagnosis just a finding

Question 18

What is haemolytic anaemia

Answer 18

premature destruction of functional erythrocytes by intrinsic and extrinsic mechanisms

Question 19

Why would anaemia develop from haemolytic anaemia

Answer 19

if the bone marrow is unable to match the destruction of erythrocytes

Question 20

name 2 immune mediated haemolytic anaemia

Answer 20

allo-immune haemolysis

Auto-immune haemolytic anaemia

Question 21

what is allo-immune haemolysis

Answer 21

allo-antibodies produced bc of immune recognition of foreign erytrocytes (via blood transfusion or pregnancy)

Question 22

An example of allo-immune haemolysis=

Answer 22

Haemolytic disease of the newborn

Question 23

Haemolytic disease of the newborn involves what antibodies from the mother

Answer 23

IgG

Question 24

In haemolytic disease of the newborn what is present in the fetal blood

Answer 24

many erythroblasts (immature RBC)

Question 25

What is autoimmune haemolytic anaemia (AIHA)

Answer 25

patients immune system produces antibodies that recognise their own erythrocytes and mediate there destruction

Question 26

Most common causes of auto-immune haemolytic anaemia ;

Answer 26

``` Lymphoproliferative disorders Autoimmune disorders (e.g Crohn's, ulcerative colitis) ```

Question 27

What can cause drug induced auto-immune haemolytic anaemia

Answer 27

penicillin

Question 28

What does immune haemolytic anaemia look like on a blood film

Answer 28

``` Spherocytes schisocytes polychromasia nucleated erythrocytes reticulocytes present ```

Question 29

What colour are reticulocytes on a blood film

Answer 29

blue

Question 30

What is a spherocyte

Answer 30

round RBC (in most haemolytic anaemias)

Question 31

What is a schisocyte

Answer 31

fragmented RBC

Question 32

what is polychromasia

Answer 32

Many immature RBC in circulation

Question 33

What is haemoglobinopathy

Answer 33

autosomal co-dominant genetic defects

Question 34

What does haemoglobinopathy cause

Answer 34

abnormal structure of the globin chains of haemoglobin molecule

Question 35

What mutated gene causes sickle cell anaemia

Answer 35

mutations in the beta-globin gene

Question 36

What does sickle cell anaemia cause

Answer 36

vaso-occlusive crises

Question 37

What does iron deficiency anaemia look like on a blood film

Answer 37

hypochromic (pale) microcytes (small) (lack of staining in centre of cell)

Question 38

Sources of iron (3)

Answer 38

Dark-green leafy veg whole grains meat

Question 39

4 things that make absorption harder

Answer 39

tea and coffee Calcium antacids PPI

Question 40

What is sideroblastic anaemia

Answer 40

failure of iron to be incorporated into haem in erythrocyte precursor cells

Question 41

What is the feature of sideroblastic anaemia

Answer 41

iron rich mitochondria surrounding the nucleus of the erythocyte precursor as granules

Question 42

Anaemia arising from lack of which vitamins ?

Answer 42

B6, B12, folate

Question 43

Where is haem molecule synthesized

Answer 43

in the cytoplasm and mitochondria of erythrocyte progenitor cells

Question 44

What are vitamin B6, B12 and folate used in

Answer 44

Haem production

Question 45

What is pernicious anaemia

Answer 45

When the body can't absorb enough vitamin B12 | gastric intrinsic factor

Question 46

B12 and folate are essential for;

Answer 46

DNA synthesis in erythocyte proliferation

Question 47

What do deficiencies in Vitamin B12 and folate cause

Answer 47

reduction in erythropoiesis

Question 48

HB=

Answer 48

haemoglobin

Question 49

RBC=

Answer 49

Red blood cell

Question 50

MCV =

Answer 50

mean corpulscular (cell) volume

Question 51

HCT=

Answer 51

haematocrit (proportion of blood made up of cells)

Question 52

MCH=

Answer 52

mean corpuscular haemoglobin

Question 53

MCHc=

Answer 53

MCH concentration

Question 54

RDW=

Answer 54

red blood cell distribution width

Question 55

A low MCV and low RBC count-->

Answer 55

Iron deficiency sideroblastic chronic infection

Question 56

A low MCV (microcytic) and high RBC count

Answer 56

thalassemias

Question 57

Normal MCV (normocytic)

Answer 57

haemolytic anaemia bone marrow disorders acute blood loss

Question 58

High MCV (macrocytic)

Answer 58

vitamin B12 deficiency folic acid deficiency liver disease hypothyrodism

Question 59

Macrocytic= Fat RBC

Answer 59

Folate deficiency Alcohol Thyroid Reticulocytosis B12 / pernicous deficiency Cytotoxic drugs

Question 60

How to treat pernicious anaemia

Answer 60

hydroxocobalamin