Normocytic anaemia

Question 1

Define

Answer 1

MCV 80–100 fl

Question 2

Causes

Answer 2

Causes:

Decreased production of normal-sized blood cells (e.g. anaemic of chronic disease, aplastic anaemia)

Increased production of HbS (sickle cell disease)

Increased destruction of red blood cells (e.g. haemolysis, post-haemorrhagic anaemia)

Uncompensated increase in plasma volume (e.g. pregnancy, fluid overload)

Vitamin B2 deficiency

Vitamin B6 deficiency

Question 3

Symptoms

Answer 3

Due to the underlying cause or to the anaemia itself
→Fatigue, dyspnoea, faintness, palpitations, headache, tinnitus, anorexia
±Angina if there is pre-existing coronary artery disease

Haemolysis will present with jaundice and ↑unconjugated bilirubin

Question 4

Signs

Answer 4

May be absent even in severe

• Pallor (e.g. conjunctivae)
• Sign of hyper-dynamic circulation (if severe), such as

tachycardia, flow murmurs, cardiac enlargement (later HF may occur)

Question 5

Investigations

Answer 5

ACD → ↓serum iron, transferrin and total iron binding capacity Normal or raise ferritin due to ↑storage and retention within reticuloendothelial system and immune activation

Question 6

Management

Answer 6

treatment of underlying cause Can give erythropoietin if indicated