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TCA 11 - Anaemia > Microcytic, hypochromic anaemia > Flashcards

Microcytic, hypochromic anaemia Flashcards

1
Q

What does high hepcidin cause?

A

Ferroportin (Fe+ transport protein) degrades

Prevents iron release from enterocytes into bloodstream and trapping of iron in marrow macrophages

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2
Q

What increases hepcidin release?

A

IL-6 and high transferrin (allows iron to be transferred in blood) saturation

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3
Q

What does a decrease in hepcidin cause?

A

Promotes iron absorption from the gut and release from the marrow macrophages to assist in erythropoiesis

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4
Q

Why do patients with chronic haemolysis become iron overloaded?

A

High levels of growth differentiation factor 15 (GDF15) inhibits hepcidin

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5
Q

What causes iron-deficiency anaemia?

A
  1. Inadequate iron-containing foods in the diet
  2. Malabsorption (coeliac disease, milk, tea)
  3. Blood loss
  4. Hookworm
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6
Q

What is the most common cause of iron-deficiency anaemia in toddlers?

A

Cow’s milk

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7
Q

What is the most common cause of iron-deficiency anaemia in pre-menopausal females?

A

Menorrhagia

15% of Caucasian women have vWD

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8
Q

What is the most common cause of iron-deficiency anaemia in men and post-menopausal women?

A

GI bleeds

  • Colonic and gastric cancers must be excluded
  • NSAIDs and aspirin
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9
Q

What is pica in iron-deficiency anaemia?

A

Craving non-food items to eat

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10
Q

What diagnoses iron-deficiency anaemia?

A
  • Low Hb
  • Decreased MCV
  • Decreased MCH
  • Decreased MCHC
  • Microcytic, hypochromic anaemia with anisocytosis and poikliocytosis
  • Decreased ferritin (iron stores)
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11
Q

What is anisocytosis?

A

Different cell sizes

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12
Q

What is poikilocytosis?

A

Oddly shaped cells

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13
Q

What can make ferritin levels increase?

A

It is an acute reactant protein

- Inflammation

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14
Q

What can make ferritin levels decrease?

A

Infancy

Adolescence

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15
Q

How would you treat iron-deficiency anaemia

A

Ferrous sulphate 200mg 2/3 times per day

Continue for 3 months

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16
Q

When would you continue a patient on ferrous sulphate after the 3 months?

A 
200mg o.d.
•	Recurring anaemia
•	Iron-poor diet
•	Malabsorption
•	Menorrhagia 
•	Had a gastrectomy
17
Q

What are the side effects of ferrous sulphate?

A
  • GI discomfort
  • Constipation/diarrhoea
  • Black stools
18
Q

What drug would you change to if the side effects of ferrous sulphate are too much?

A

Ferrous fumarate

19
Q

What can ferrous sulphate reduce the absorption of?

A
  • Quinolone
  • Tetracyclines
  • Levodopa
  • Bisphosphonates
  • Zinc
  • Levothyroxine
  • Calcium products
20
Q

How do you monitor iron-deficiency anaemia?

A

Check Hb levels 2-4 weeks after supplementation

- Hb should rise by 2g/100mL over 3-4 weeks

21
Q

What is thalassaemia?

A

Defects in alpha or beta chain of Hb.

22
Q

What is thalassaemia’s pattern of inheritance

A

Autosomal recessive

23
Q

What type of anaemia is thalassameia?

A

Microcytic and haemolytic

24
Q

What diagnoses thalassaemia?

A
  • Low Hb
  • Microcytic, hypochromic RBCs with anisocytosis and poikilocytosis
  • Hb electrophoresis
  • DNA testing
  • HbA2
  • HbF
  • Genetic testing
25
Q

What is thalassaemia trait/minor?

A

One abnormal beta gene

Raised HbA2

26
Q

What is thalassaemia intermedia?

A

Synthesis of beta chains are less severely reduced

27
Q

What is thalassaemia major?

A

2 abnormal beta genes so have no HbA

28
Q

What are signs of thalassaemia major?

A
  • Abdominal swelling
  • Growth retardation
  • Irritability
  • Jaundice
  • Pallor
  • Skeletal abnormalities
  • Splenomegaly
29
Q

What does 3 deleted alpha Hb genes cause?

A

HbH

Microcytic anaemia, haemolysis and splenomegaly

30
Q

What does 4 deleted alpha Hb genes cause?

A

HbBarts

Fatal hydrops fetalis

31
Q

What causes secondary anaemia?

A
  1. Poor use of iron in erythropoiesis
  2. Cytokine-induced shortening of RBC survival
  3. Reduced production of and response to erythropoietin

TCA 11 - Anaemia (5 decks)

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