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_Haematology > Microcytic anaemia > Flashcards

Microcytic anaemia Flashcards

1
Q

What is microcytic anaemia?

A

type of anaemia where the circulating RBCs are smaller than normal

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2
Q

What does MCV stand for?

A

mean corpuscular volume

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3
Q

what does MCV measure?

A

avg volume of a RBC

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4
Q

what’s the normal MCV range?

A

80-100 fL (femto = 10^-15)

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5
Q

Microcytic anaemia is defined by what MCV?

A

<80 fL

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6
Q

What are the three types of microcytic anaemia we need to know about?

A

Fe deficiency
alpha and beta thalassemia
sideroblastic

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7
Q

Give three symptoms of anaemia

A

fatigue
palpitations
pale skin

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8
Q

Why does iron deficiency lead to anaemia?

A

Iron is needed in haem formation
lack of haem = lack of effective RBCs

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9
Q

Give four causes of iron deficiency?

A
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10
Q

What percentage of men and women are iron deficient in the UK?

A

2% of men
14% of non-pregnant women and 38% in pregnant women

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11
Q

Diagnostic criteria of iron deficiency?

A

Serum ferritin < 30 mg/L
results affected by:
infection
inflammation
pregnancy

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12
Q

Treatment for iron deficiency?

A

oral iron tablets continued for 3 months after iron deficiency cleared:
ferrous sulfate
ferrous fumarate
ferrous gluconate

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13
Q

How long should iron tablets be continued after the iron deficiency is resolved?

A

3 months

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14
Q

What three ferrous tablets can be given for iron deficiency?

A

ferrous sulfate
ferrous fumarate
ferrous gluconate

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15
Q

Diagnostic definition of anaemia in males and females (pregnant and non-pregnant)?

A

males - Hb < 130 g/L
females - Hb < 120 g/L
females (pregnant) - Hb < 110 gL

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16
Q

Two common signs of iron deficiency?

A

pallor
atrophic glossitis (loss of papillae on the tongue)

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16
Q

Two common signs of iron deficiency?

A

pallor
atrophic glossitis (loss of papillae on the tongue)

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17
Q

Describe the structure of a haemoglobin molecule?

A
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18
Q

Roughly how many molecules of haemoglobin are in each red blood cell?

A

260 million

19
Q

Roughly how many red blood cells circulate in the average person?

A

25 trillion

20
Q

three side effects of iron tablets?

A

black stools
constipation
nausea

21
Q

What is thalassaemia?

A

an inherited blood disorder characterised by decreased haemoglobin production

22
Q

What mode of inheritance is thalassaemia?

A

AR

23
Q

What happens to the RBCs in thalassaemia?

A

They’re more fragile and break down easily

24
Q

What can happen to the spleen in thalassaemia?

A

spleen collects all the destroyed blood cells and swells (splenomegaly)

25
Q

In chronic anaemia what can happen to bone marrow?

A

It can swell in order to try and produce more RBCs to compensate for the chronic anaemia

26
Q

What three things can be used to diagnose thalassaemia?

A

FBC - microcytic anaemia
Haemoglobin electrophoresis - diagnose globin abnormalities
DNA testing - find the genetic abnormality

27
Q

Why is iron overload a risk in thalassaemia?

A

faulty RBCs can’t uptake iron, so it deposits in organs around the body.

28
Q

What chromosome number is the alpha-globin producing gene on?

A
29
Q

What chromosome number is the beta-globin producing gene on?

A
30
Q

How many genes are potentially affected in alpha-thalassaemia?

A

4 genes.
No. affected:

1 or 2 = alpha-thalassaemia minor (usually asymptomatic)
3 = haemoglobin H disease (moderate anaemia)
4 = alpha-thalassaemia major (incompatible with life)

31
Q

How many genes are potentially affected in beta-thalassaemia?

A

2 genes

No. affected:
1 = beta-thalassaemia minor
2 = beta-thalassaemia major

32
Q

How does a diagnosis of beta-thalassaemia help?

A

Rules out misdiagnosis of iron deficiency + informs for prenatal counselling

32
Q

How does a diagnosis of beta-thalassaemia help?

A

Rules out misdiagnosis of iron deficiency + informs for prenatal counselling

33
Q

What versions of alpha-thalassaemia are caused by different numbers of genes being affected?

A

No. of genes affected:
1 or 2 = alpha-thalassaemia minor (usually asymptomatic)
3 = haemoglobin H disease (moderate anaemia)
4 = alpha-thalassaemia major (incompatible with life)

34
Q

what versions of beta-thalassaemia are caused by different numbers of genes being affected?

A

No. of genes affected:
1 = beta-thalassaemia minor (asymptomatic)
2 = beta-thalassaemia major (severe anaemia and other problems from 3-6 months)

35
Q

What age does the body start producing adult haemoglobin (HbA) instead of foetal haemoglobin (HbF)?

A

3-6 months

36
Q

When is most thalassaemia major detected?

A

at or before birth (antenatal or newborn screening)

37
Q

Give two ways beta-thalassaemia major can be managed?

A

Regular transfusions (every 4-6 weeks)
Iron chelation to avoid iron overload

38
Q

Iron chelation therapy is a way to reduce the risk of iron overload. Give the name of a drug used for this.

A

desferrioxamine

39
Q

When is thalassaemia screened for in pregnant women in the UK?

A

Pregnant women should be offered a blood test before 10 weeks gestation which will identify for thalassaemia carriers.

40
Q

When is thalassaemia screened for in pregnant women in the UK?

A

Pregnant women should be offered a blood test before 10 weeks gestation which will identify for thalassaemia carriers.

41
Q

What happens in sideroblastic anaemia?

A

body has enough iron but can’t incorporate it into haem

42
Q

In sideroblastic anaemia, deficiency of what molecule inhibits the bodies ability to incorporate iron into haem?

A

protoporphyrin

43
Q

in sideroblastic anaemia, iron accumulates within RBCs maturing in the bone marrow. What cells are produced instead of RBCs?

A

ringed sideroblasts

44
Q

in sideroblastic anaemia, ringed sideroblasts are produced instead of healthy RBCs by the bone marrow. Where in these cells is iron accumulated?

A

Within the mitochondria, which go on to form a ring around the nucleus.

_Haematology (14 decks)

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