Microcytic anaemia Flashcards
What would MCV, serum iron, transferrin sats, ferritin and transferrin be like in a patient with microcytic anaemia?
MCV = Reduced (can be normal) Serum iron = Reduced Transferrin sats = Reduced Ferritin = Reduced Transferrin = Normal (can be raised)
What would MCV, serum iron, transferrin sats, ferritin and transferrin be like in a patient with anaemia of chronic disease?
MCV = Low or normal Serum iron = Reduced Transferrin sats = Reduced Ferritin = Normal/Raised Transferrin = Normal/Reduced
What are 3 causes of IDA?
- Menorrhagia
- Poor dietary intake
- Reduced absorption (e.g. coeliac disease)
What do the levels of serum ferritin reflect?
The amount of stored iron, however, due to it’s role as an acute phase protein, can be elevated in chronic inflammation/disease.
What is usually causative for a Beta-thalassaemia?
Point mutation in Beta globin genes on chromosome 11.
Why do signs of Beta-thalassaemia only present themselves 6mths or so after birth?
Conversion of HbF to HbA; 2 alpha 2 delta changes to 2 beta 2 alpha.
What is usually causative for an Alpha-thalassaemia and why is it less likely to cause symptoms when compared with a B-thalassaemia?
Gene deletions on chromosome 16; represented twice on each gene (4-alpha) so greater ability to compensate for dysfunctional/non-present genes.
Which globin chain is implicated in sickle-cell and when do sickle cells arise?
Beta; when deoxygenated (or exposed to low oxygen for a prolonged time) HbS polymerises causing RBCs to deform, producing sickle cells.
State 2 instances where “sickling” may occur in someone with sickle trait
At high altitude and under anaesthesia.
What is involved in the acute management of a sickle crisis?
- Opiate analgesia, hydration, rest, oyxgen, Abx if evidence of infection.
- Red cel exchange transfusion in severe crisis (e.g. chest or neurological symptoms).
