Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Yr 3 Haem > microcytic anaemia > Flashcards

microcytic anaemia Flashcards

1
Q

definition of microcytic anaemia

A

Anaemia associated with low MCV (<80 fl).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

aetiology of microcytic anaemia

A

iron deficiency commonest cause

anaemia of chronic disease - often normocytic, can be monocytic

thalassaemia

sideroblastic anaemia

lead poisoning (eg in scrap metal or smeltering workers) - interferes with globin and haem synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

aetiology of IDA

A

blood loss eg GIT, urogenital tract, hookworm infection, menorrhagia

reduced absorption - small bowel disease, post-gastrectomy, coelic (refractory IDA)

increased demand - pregnancy, growth

reduced intake - vegans, poor diet or poverty in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

sideroblastic anaemia

A

abnormality of haem synth

can be inherited (x-linked)

secondary to alcohol, drugs (eg isoniazid, chloramphenicol), lead, myelodysplasia/myeloproliferation

chemo

irradiation

alcohol

NOT IRON DEFICIENT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

epidemiology of microcytic anaemia

A

Iron-deficiency anaemia is the commonest form of anaemia worldwide.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

sx of microcytic anaemia

A

tiredness

lethargy

malaise

dyspnoea

pallor

exacerbation of pre-existing angina or intermittent claudication

FH of causitive disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

lead poisening sx

A

anorexia

nausea

vomiting

abdominal pain

constipation

peripheral nerve lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

signs of microcytic anaemia

A

signs of anaemia

  • pallor of skin and mucous membranes
  • brittle nails and hair
  • if long standing and severe - koilonychia

glossitis - atrophy of tongue papillae

cheilitis - angular stomatitis

signs of thalassaemia

signs of lead poisoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

signs of lead poisoning

A

blue gumline

peripheral nerve lesions - wrist/foot drop

encephalopathy

convulsions

reduced consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ix for microcytic anaemia

A

blood

blood film

Hb electrophoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

blood results if microcytic anaemia

A

FBV - low Hb, low MCV, reticulocytes

serum iron - low in ID

iron binding capacity - increased in ID

serum ferritin - low in ID

serum led - if poisoning suspected

in thalassaemia and sideroblastic anaemia - hogh serum iron and ferritin and low total iron binding capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

blood film in IDA

A

microcytic, hypochromic (central pallor >1/3 cell size),

anisocytosis (variable cell size)

poikilocytosis (variable cell shape)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

blood film in sideroblastic anaemia

A

dimorphic blood film with a population of hypochromic microcytic cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

blood film for lead poisoning

A

basophilic stippling - coarse dots represent condensed RNA in cytoplasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hb electrophoresis for microcytic anaemia

A

for Hb variants for thalassaemias

sideroblastic anaemia

  • ring sideroblasts in bone marrow, iron deposited in perinuclear mitochondria of erythroblasts, stain blue-green with Perls’ stain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ix if iron-deficiency anaemia in>40 years and post-menopausal women

A

upper GI endoscopy

colonoscopy

investigations for haematuria

all should be considered if no obvious cause of blood loss

17
Q

Mx for IDA

A

oral iron supplements eg 200mg ferrous sulphate tablets containing 65mg of elemental iron, 2 or 3x daily taken with food

SE - nausea, abdo discomfort, diarrhoea/constipation, black stools

If oral iron intolerance or malabsorption or functional iron deficiency in chronic renal failure where inadequate mobilisation of iron stores in response to erythropoetin therapy - consider parenteral iron supplements (beware risk of anaphylaxis).

monitor Hb and MCV, aiming for Hb rise of 1g/dL/week. Modest reticulocytosis

continue for at least 3mo

18
Q

Mx of sideroblastic anaemia

A

treat the cause - stop causative drug

pyridoxine can be used in inherited forms

if no response - blood transfusion and iron chelation

19
Q

Mx of lead poisoning

A

remove source

dimercaprol

D-penicillamine

Ca2+ EDTA

20
Q

complications of microcytic anaemia

A

high output cardiac failure

complications of the cause

21
Q

prognosis of microcytic anaemai

A

depends on cause

22
Q

signs of IDA

A

koilonychia

atrophic glossitis

angular cheilosis

post-cricoid webs (Plummer-Vinson syndrome)

23
Q

Ix results for IDA

A

blood film:

  • microcytic
  • hypochromic anaemia
  • anisocytosis
  • poikilocytosis

blood

  • low MCV, MCH< MCHC
  • low ferritin
  • low iron
  • high TIBC (transferrin)

check coelic serology - if -ve refer men adn women not menstruating to gastroscopy and colonscopy

stool microscopy for ova if relevant travel history

24
Q

ferritin

A

acute phase protein

increases with inflammation eg infection and malignancy

25
Q

anaemia of chronic disease

A

most common anaemia in hospital patients

arises from 3 problems - hepcidin plays a role (stops iron uptake and transport, and increases storage)

  • poor use of iron in erythropoiesis
  • cytokine-induced shortening of RBC survival
  • reduced production of and response to erythropoietin
26
Q

aetiology of anaemia of chronic disease

A

chronic infection

vasculitis

rheumatoid

malignancy

renal failure

27
Q

Ix results for anaemia of chronic disease

A

ferritin normal or high in mild normocytic or microcytic anaemia

check blood film, B12, folate, TSH and test for haemolysis

low iron

low TIBC

high ferritin

28
Q

Mx of anaemia of chronic disease

A

treat underlying disease

erythropoietin - SE - flu like sx, HTN, mild rise in platelet count and thromboembolism

effective in improving the QOL in malignant disease

IV iron can overcome functional iron deficiency

29
Q

pathology of sideroblastic anaemia

A

ineffective erythropoiesis = increased iron absorption, iron loading in marrow +- haemosiderosis (endocrine, liver and heart damage due to iron deposition)

30
Q

Ix results fo sideroblastic anaemia

A

high ferritin

hypochromic blood film

disease-defining sideroblasts in marrow

31
Q

interpreting iron studies

A

Yr 3 Haem (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions