Normocytic anaemia Flashcards
Causes of normocytic anaemia
Aplastic anaemia
Haemolytic anaemia
Sickle cell anaemia
Causes of aplastic anaemia
Congenital aplasia
Chemo
HIV
Blood result abnormalities in aplastic anaemia
Pancytopenia
Low reticulocytes
Appearance of bone marrow in aplastic anaemia
Hypocellular
Increased fat
Categories of haemolytic anaemia
Extravascular - within reticuloendothelial system
Intravascular - within blood vessels
Causes of haemolytic anaemia
Hereditary spherocytosis/elliptocytosis SCD/thalassaemia Autoimmune haemolytic anaemia Transfusion reaction Glucose-6-phosphate dehydrogenase deficiency Pyruvate kinase deficiency Malaria Quinine Haemolytic-uraemic syndrome
Clinical features of haemolytic anaemia
Jaundice
Hepatosplenomegaly
Investigations for haemolytic anaemia
FBC Reticulocytes Bilirubin Urine urobilinogen Direct Coombs test - positive = autoimmune
Different types of haemoglobin and their component chains
HbF - 2 alpha and 2 gamma
HbA1 - 2 alpha and 2 beta
HbA2 - 2 alpha and 2 delta
Gene defect in sickle cell disease
A-T substitution leading to glutamate to valine substitution on beta globin chain
Clinical features of sickle cell disease
Jaundice
Splenomegaly
Microvascular occlusion - swollen hands and feet (dactylitis), mesenteric ischaemia, TIA
Priapism
What drug can raise HbF production in haemoglobinopathies
Hydroxycarbamide
Features of extravascular and intravascular haemolytic anaemia
Extra: splenomegaly
Intra: raised plasma Hb, haemoglobinuria (red/brown urine)
What prophylaxis should sickle cell patients receive
Pneumococcal vaccine due to splenic infarcts
Management for sickle cell crisis
Generous analgesia Keep warm and hydrated Group and cross match Blood cultures to screen for sepsis - consider empiric ABx if fever or any lung symptoms Blood transfusion if Hb falls sharply
