Microcytic anaemia

Question 1

Low haemoglobin can be caused by 4 pathologies, what are they?

Answer 1

DUE TO LOW RED CELL MASS
OR
INCREASED PLASMA
VOLUME (DILUTION)

REDUCED PRODUCTION

AND/OR

INCREASED LOSS.

Question 2

What are the symptoms of anaemia?

Answer 2

FATIGUE

DYSPNOEA

FAINTNESS

PALPITATIONS

HEADACHES

TINNITUS

ANOREXIA

ANGINA (IN PRE-EXISTING CORONARY ARTERY DISEASE)

Question 3

What are the cardiac signs of anaemia?

Answer 3

PALLOR

HYPERDYNAMIC CIRCULATION

• TACHYCARDIA
• FLOW MURMURS (EJECTION)
• CARDIAC ENLARGEMENT

RETINAL HAEMORRHAGES
HEART FAILURE

Question 4

What is the cause of microcytic anaemia?

Answer 4

IRON DEFICIENCY ANAEMIA

THALASSAEMIA

SIDEROBLASTIC ANAEMIA

Question 5

What are the causes of normocytic anaemia?

Answer 5

ACUTE BLOOD LOSS

ANAEMIA OF CHRONIC DISEASE

BONE MARROW FAILURE

RENAL FAILURE

HYPOTHYROIDISM (OR HIGH MCV)

HAEMOLYSIS (OR HIGH MCV)

PREGNANCY
‘
MIXED’ DEFICIENCY (EG IRON DEFICIENCY PLUS B12 DEFICIENCY)

Question 6

List 4 causes of iron deficiency anaemia

Answer 6

Blood loss (GI bleed, menorrhagia)

Poor diet

Malabsorption

GI parasites (hookworms)

Question 7

What are the signs of iron deficiency anemia?

Answer 7

KOILONYCHIA

ATROPHIC GLOSSITIS

ANGULAR CHEILOSIS

POST-CRICOID WEB (PLUMMER-VINSON SYNDROME)

Tape worm

Question 8

For iron deficiency anaemia, what can be seen on the blood film?

Answer 8

Microcytic hypochromic anaemia

Anisocytosis (variation in RBC size)

Poikilocytosis (variation in RBC shape)

Question 9

On an irone screen, what can be seen?

Answer 9

Low SE Ferritin

Low SE iron

Question 10

When investigating iron deficiency anaemia, which other investigations should be conducted?

Answer 10

Coeliac screen
Gastroscopy
Colonoscopy

Question 11

How is iron deficiency treated?

Answer 11

Iron tablets
If coeliac disease - gluten free diet
Treat underlying condition