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Block 4 Ellen > Mechanisms of anaemia L2 > Flashcards

Mechanisms of anaemia L2 Flashcards

1
Q

Anaemia definition

A

reduced number of RBC in circulation or decreased haemoglobin

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2
Q

What does anaemia result in

A

reduced levels of oxygen delivery to tissues

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3
Q

Signs of anaemia; (5)

A 
pallor
tachycardia (pulse>100 bpm) 
Glossitis
koilonychia 
Dark urine
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4
Q

What is koilonychia

A

spoon nails

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5
Q

what is glossitis

A

swollen and painful tongue

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6
Q

Symptoms of anaemia: (4)

A 
fatigue
weakness
dizziness 
palpations 
shortness of breath
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7
Q

Erythropoesis=

A

production of RBC

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8
Q

Precursor of RBC

A

Reticulocyte

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9
Q

What is pure red cell aplasia (PRCA)

A

conditions affecting specifically erythropoiesis in the bone marrow

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10
Q

Most common type of pure red cell aplasia

A

diamond-blackfan anaemia

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11
Q

What is Diamond-blackfan anaemia

A

congenital reduced proliferation of erythroblasts

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12
Q

What is aquired (secondary) Pure red cell aplasia

A

acquired as exposure to pathogenic agents or drug or infection

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13
Q

What can cause anaemia through changes in bone marrow

A

congenital
infections
malignancy
autoimmune disease

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14
Q

What do most conditions in the bone marrow cause

A

pancytopenia and aplastic anaemia in addition to red cell aplasia

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15
Q

What is aplastic anaemia

A

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

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16
Q

Failure of haematopoietic stem cells will lead to

A

pancytopenia

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17
Q

pancytopenia=

A

deficiency of all three cellular components of blood

not a diagnosis just a finding

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18
Q

What is haemolytic anaemia

A

premature destruction of functional erythrocytes by intrinsic and extrinsic mechanisms

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19
Q

Why would anaemia develop from haemolytic anaemia

A

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

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20
Q

name 2 immune mediated haemolytic anaemia

A

allo-immune haemolysis

Auto-immune haemolytic anaemia

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21
Q

what is allo-immune haemolysis

A

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

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22
Q

An example of allo-immune haemolysis=

A

Haemolytic disease of the newborn

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23
Q

Haemolytic disease of the newborn involves what antibodies from the mother

A

IgG

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24
Q

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

A

many erythroblasts (immature RBC)

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25
Q

What is autoimmune haemolytic anaemia (AIHA)

A

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

26
Q

Most common causes of auto-immune haemolytic anaemia ;

A 
Lymphoproliferative disorders 
Autoimmune disorders (e.g Crohn's, ulcerative colitis)
27
Q

What can cause drug induced auto-immune haemolytic anaemia

A

penicillin

28
Q

What does immune haemolytic anaemia look like on a blood film

A 
Spherocytes 
schisocytes 
polychromasia 
nucleated erythrocytes 
reticulocytes present
29
Q

What colour are reticulocytes on a blood film

A

blue

30
Q

What is a spherocyte

A

round RBC (in most haemolytic anaemias)

31
Q

What is a schisocyte

A

fragmented RBC

32
Q

what is polychromasia

A

Many immature RBC in circulation

33
Q

What is haemoglobinopathy

A

autosomal co-dominant genetic defects

34
Q

What does haemoglobinopathy cause

A

abnormal structure of the globin chains of haemoglobin molecule

35
Q

What mutated gene causes sickle cell anaemia

A

mutations in the beta-globin gene

36
Q

What does sickle cell anaemia cause

A

vaso-occlusive crises

37
Q

What does iron deficiency anaemia look like on a blood film

A

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

38
Q

Sources of iron (3)

A

Dark-green leafy veg
whole grains
meat

39
Q

4 things that make absorption harder

A

tea and coffee
Calcium
antacids
PPI

40
Q

What is sideroblastic anaemia

A

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

41
Q

What is the feature of sideroblastic anaemia

A

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

42
Q

Anaemia arising from lack of which vitamins ?

A

B6, B12, folate

43
Q

Where is haem molecule synthesized

A

in the cytoplasm and mitochondria of erythrocyte progenitor cells

44
Q

What are vitamin B6, B12 and folate used in

A

Haem production

45
Q

What is pernicious anaemia

A

When the body can’t absorb enough vitamin B12

gastric intrinsic factor

46
Q

B12 and folate are essential for;

A

DNA synthesis in erythocyte proliferation

47
Q

What do deficiencies in Vitamin B12 and folate cause

A

reduction in erythropoiesis

48
Q

HB=

A

haemoglobin

49
Q

RBC=

A

Red blood cell

50
Q

MCV =

A

mean corpulscular (cell) volume

51
Q

HCT=

A

haematocrit (proportion of blood made up of cells)

52
Q

MCH=

A

mean corpuscular haemoglobin

53
Q

MCHc=

A

MCH concentration

54
Q

RDW=

A

red blood cell distribution width

55
Q

A low MCV and low RBC count–>

A

Iron deficiency
sideroblastic
chronic infection

56
Q

A low MCV (microcytic) and high RBC count

A

thalassemias

57
Q

Normal MCV (normocytic)

A

haemolytic anaemia
bone marrow disorders
acute blood loss

58
Q

High MCV (macrocytic)

A

vitamin B12 deficiency
folic acid deficiency
liver disease
hypothyrodism

59
Q

Macrocytic= Fat RBC

A

Folate deficiency
Alcohol
Thyroid

Reticulocytosis
B12 / pernicous deficiency
Cytotoxic drugs

60
Q

How to treat pernicious anaemia

A

hydroxocobalamin

Block 4 Ellen (10 decks)

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