New GP Derm Flashcards

1
Q

Define anaemia

A

Low concentration of haemoglobin in the blood

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1
Q

What is the Mean Cell Volume (MCV) in both females and males?

A

80-100 femtolitres

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2
Q

What are the categories of anaemia?

A

Categories based on mean cell volume:
* Microcytic anaemia (low MCV)
* Normocytic anaemia (normal MCV)
* Macrocytic anaemia (large MCV)

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3
Q

Mneumonic for microcytic anaemia

A

TAILS

T – Thalassaemia
A – Anaemia of chronic disease
I – Iron deficiency anaemia
L – Lead poisoning
S – Sideroblastic anaemia

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4
Q

What condition does anaemia of chronic disease often occur with? Why?

A

Chronic kidney disease (CDK) - due to reduced production of erythropoietin by the kidneys

Erythropoietin = hormone responsible for stimulating RBC production

Treatment = erythropoietin

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5
Q

Nmeumonic for normocytic anaemia

A

3 As + 2 Hs

A – Acute blood loss
A – Anaemia of chronic disease
A – Aplastic anaemia
H – Haemolytic anaemia
H – Hypothyroidism

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6
Q

What are the types macrocytic anaemia?

A

Normoblastic anaemia (H LARD):
* H- Hypothyroidism
* L - Liver disease
* A - Alcohol
* R - Reticulocytosis (usually from haemolytic anaemia or blood loss)
* D - Drugs (e.g. azathioprine)

Megaloblastic anaemia:
* B12 deficiency
* Folate deficiency

Megalobastic anaemia → deficiencies so don’t divide → big abnormal cells

Megalobastic anaemia → deficiencies → impaired DNA synthesis → don’t divide → big abnormal cells

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7
Q

What are the two main categories of macrocytic anaemia?

A

Normoblastic + megaloblastic

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8
Q

What causes megaloblastic anaemia?

A

Megaloblastic macrocytic anaemia = results from impaired DNA synthesis → preventing the cells from dividing normally

Rather than dividing → they grow into large abnormal cells

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9
Q

What is reticulocytsosis?

A

Reticulocytosis **= increased concentration of reticulocytes (immature RBCs) **

Happens where there is a rapid turnover of RBCs → such as haemolytic anaemia or blood loss

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10
Q

What are the generic symptoms of anaemia?

A
  • Tiredness
  • Shortness of breath
  • Headaches
  • Dizziness
  • Palpitations
  • Worsening of other conditions, such as angina, heart failure or peripheral arterial disease
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11
Q

What are two symptoms/signs specific to iron deficiency anaemia?

A
  • Pica (dietary cravings for abnormal things, such as dirt or soil)
  • Hair loss
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12
Q

What are the generic signs of anaemia?

A
  • Pale skin
  • Conjunctival pallor
  • Tachycardia
  • Raised respiratory rate
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13
Q

What are some specific signs for iron deficiency anaemia?

A
  • Koilonychia (spoon-shaped nails)
  • Angular cheilitis
  • Atrophic glossitis (smooth tongue due to atrophy of the papillae)
  • Brittle hair + nails
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14
Q

What type of anaemia can jaundice indicate?

Think about it

A

Haemolytic anaemia

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15
Q

Bone deformities can be a sign for what blood disorder (form of microcytic anaemia)?

A

Thalassaemia

16
Q

What can the signs below indicate:
* Oedema
* Hypertension
* Excoriations on the skin

A

Chronic kidney disease

17
Q

What are the investigations (imaging) for unexplained iron deficiency anaemia to exclude gastrointestinal cancer as a source of bleeding?

A
  • Oesophagogastroduodenoscopy (OGD)
  • Colonoscopy
18
Q

What investigation is indicated for unexplained anaemia or possible malignancy (e.g. leukaemia or myeloma)?

A

Bone marrow biopsy

19
Q

Blood tests for anaemia

A
  • Full blood count (Hb + MCV)
  • Reticulocyte count (indicates red blood cell production)
  • Blood film (abnormal cells and inclusions)
  • Renal profile (chronic kidney disease)
  • Liver function tests (liver disease and bilirubin (raised in haemolysis))
  • Ferritin (iron)
  • B12 and folate
  • Intrinsic factor antibodies (pernicious anaemia)
  • Thyroid function tests (hypothyroidism)
  • Coeliac disease serology (e.g., anti-tissue transglutaminase antibodies)
  • Myeloma screening (e.g., serum protein electrophoresis)
  • Haemoglobin electrophoresis (thalassaemia and sickle cell disease)
  • Direct Coombs test (autoimmune haemolytic anaemia)