Microcytic Anaemia

Question 1

Microcytic anaemia

Answer 1

anaemia where MCV >80

Question 2

examples

Answer 2

Lead poisoning
Iron Deficiency
Sideroblastic
Thalassaemia

Question 3

Iron Deficiency

Answer 3

microcytic anaemia

iron levels are low

investigations:
Ferritin
pencil red cells seen on film

reduced ferritin, high total iron binding capacity, low transferrin saturation (if there is co-occurring inflammation, then ferritin can be raised)

management:
oral intake with diet
ferrous sulphate supplements

monitor bloods often

if age 60 or over, refer to GI for colonoscopy in case of cancer

Question 4

Thalassaemia

Answer 4

autosomal recessive condition

Hb consists of 4 alpha chains and 2 beta chains

Alpha: (African and Asian)
1 faulty, 3 good - asymptomatic - hypochromic, normal Hb
2 faulty, 2 good - asymptomatic - hypochromic, microcytic
3 faulty, 1 good - mildly symptomatic - hypochromic, microcytic
4 fault - not compatible with life (alpha major)

Beta: (mediterranean)
1 faulty, 1 good - asymptomatic, HbA2 raised largely
2 faulty - symptomatic (beta major) -

manage with multiple blood transfusions, be aware of iron overload (give chelation), splenectomy

investigations:
haemoglobin electrophoresis
FBC

Question 5

sideroblastic anaemia

Answer 5

mimics iron deficiency

produces high iron and serum ferritin levels

management:
supportive

Question 6

lead poisoning

Answer 6

abdo pain
neuro signs
blue lines on gums

blood lead levels

management:
chelating agents - dimercaptosuccinic acid