Microcytic Anaemia Flashcards
What is anaemia?
A reduced red cell mass, with a lowered total haemoglobin.
What is haematocrit?
The amount of haemoglobin within the blood relative to blood volume.
Does expected haemoglobin levels differ between males and females?
Yes, males are expected to have a higher concentration.
Is haemoglobin concentration/haematocrit always a good marker of anaemia?
No, it can remain constant in acute blood loss as the loss is relative to that of the rest of the blood constituents.
Can a drip affect haemoglobin concentration?
Yes, can raise plasma volume, causing an apparent anaemia.
Measure using another blood vessel to allow for this.
What are reticulocytes?
Immature RBCs.
These will be larger and more purple than mature RBCs.
What term is used to describe the presence of different coloured RBCs in a sample?
Polychromasia
What are the 2 basic reasons for anaemia to present?
Decreased production
Increased loss/destruction
What are the common causes of microcytic anaemia?
Thalassaemia Anaemia of chronic disease Iron deficiency Lead poisoning Sideroblastic anaemia
Remember ‘TAILS’.
How is iron stored in the body?
Within the liver as ferritin.
Which protein transports iron?
Transferrin
This has 2 binding sites for iron per molecule.
What can be used to indicate iron levels within the body?
% of transferrin saturation
How is % transferrin saturation affected by iron deficiency and chronic disease?
Will be reduced.
How is % transferrin saturation affected by haemochromatosis?
Will be raised.
What is used to confirm iron deficiency anaemia?
Low functional iron
Low serum ferritin
Are MCV or ferritin levels affected first in iron deficiency?
Ferritin levels, followed by MCV as less iron is present in the body to create RBCs with.
What changes are seen long-term in iron deficiency?
Koilonychia
Angular cheilitis
What can cause iron deficiency?
Lack of dietary iron
Menorrhagia/Other bleeding
Malabsorption
Where is iron absorbed in the GI tract?
The duodenum
How is iron deficiency treated?
Iron supplementation
Find the underlying cause too.
How does iron supplementation work?
First it improves haemoglobin, then acts to re-build iron stores.
MCV will rise as reticulocytes are produced.
Expected to rise at a rate of 7-10g/L, per week.
What is a common issue with oral iron supplementation?
It can cause irritation of the small bowel.
Advise patient to take this on an empty stomach, as this aids absorption also.
What can be used second-line to oral iron, if side-effects are encountered?
Parenteral/IV iron
What side-effects are associated with oral iron supplementation?
Constipation
Nausea and vomiting
Abdominal pain
Dark stools
