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Haematology > Normochromic, normocytic anaemia > Flashcards

Normochromic, normocytic anaemia Flashcards

1
Q

What are all causes of normochromic, normocytic anaemia with a HIGH reticulocyte (haemolysis)?

A 
Inherited conditions:
Hereditary spherocytosis
Elliptocytosis
thalassaemia
sickle cell anaemia
G6PD deficiency

Acquired conditions:
Autoimmune haemolysis
anaemia
Prosthetic valve replacement haemolysis

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2
Q

What are causes of normochromic, normocytic anaemia with a normal or low reticulocyte count?

A

Secondary anaemie
hypoplasia
marrow infiltration

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3
Q

What is secondary anaemia?

A

Anaemia secondary of a chronic disease

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4
Q

What cells are usually seen in secondary anaemia?

A 
70% = normochromic, normocytic.
30% = hypochromic, microcytic.
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5
Q

What is a common cause of secondary anaemia?

A

Infection, inflammation, malignancy or renal impairment.

Increased inflammation causing increased hepcidin production.
Leads to defective iron production.

^Ferritin levels will be normal but the iron just can’t be used.

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6
Q

What tests should be done for haemolytic anaemia?

A

FBC - normochromic, normocytic cells
Blood film - shistocytes (fragments of RBCs0
Direct Coombs test (DAT/DAGT - can be + or -.

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7
Q

When is a DAT test positive?

A

when the cause of haemolysis is autoimmune

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8
Q

What are the features of haemolysing anaemia?

A

splenomegaly

jaundice

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9
Q

Why is reticulocyte increased in haemolytic anaemia?

A

the patient has increased RBC destruction - compensated by bone marrow releasing more immature RBCs (reticulocytes)

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10
Q

Where does haemolysis occur?

A

Intravascular - when erythrocytes are destroyed in the blood vessel itself.

Extravascular - occurs in the hepatic and splenic macrophages within the reticuloendothelial system.

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11
Q

What is RBCs broken down into?

A

Globin (amino acid)
Iron (reused and binds to transferrin)
Bilirubin

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12
Q

What happens to the bilirubin in the body?

A

RBC breaks down into unconjugated bilirubin - binds to albumin and is taken to the liver - is conjugated and you poop rope out the conjugated bilirubin.

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13
Q

Where does most immune mediated haemolysis occur?

A

Mostly extravascular

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14
Q

where does most non immune haemolysis occur?

A

mostly intravascular

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15
Q

What test can show of haemolysis is immune related?

A

DAT/DAGT test (direct antiglobulin test)

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16
Q

What does the DAT test show you?

A

positive - immune related

negative - non immune related

17
Q

What can cause auto immune haemolysis?

A 
autoimmune 
drugs
infection
lymphoma
blood transfusion reaction
18
Q

What is the management of autoimmune haemolytic anaemia?

A

folic acid
immunosuppression
splenectomy

19
Q

What is autoimmune haemolytic anaemia?

A

when antibodies are created against the patients red blood cells leading to destruction of the red blood cells.

Haematology (27 decks)

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