Nutritional Anaemia Flashcards
What is anaemia
Anaemia is a condition in which the number of red blood cells (and consequently their oxygen-carrying capacity) is insufficient to meet the body’s physiologic needs.
what are the 2 things needed for DNA synthesis of red blood cells
Vitamin B12 and Folic acid
what is needed for Haemoglobin synthesis
Iron
3 ways anaemia can occur
Failure of production
ineffective erythropoiesis
decreased survival
3 causes of microcytic anaemia
Iron deficiency
Thalassemia
Anaemia of chronic disease
5 causes of normocytic anaemia
Anaemia chronic disease aplastic anaemia chronic renal failure bone marrow infiltration sickle cell disease
6 causes of macrocytic
B12 deficiency/ folate deficiency Myelodysplasia Alcohol induced drug induced liver disease myxoedema
what is the name of the protein used to transport iron
transferrin
2 storage proteins of iron and where is it found
ferritin and hemosiderin
found in cells of liver, spleen and bone marrow
how is iron absorption regulated
by GI mucosal cells and hepcidin
where is iron absorbed from
duodenum and proximal jejunun
how is iron absorbed
via ferroportin receptors on enterocytes
what does hepcidin do
cause ferroportin internalisation and degradation, thereby decreasing iron transfer into blood plasma from the duodenum
Main clue for iron deficiency
Low ferritin
Iron deficiency investigation
FBC: Hb, MCV, MCH, Reticulocyte count
Iron studies: Ferritin, Transferrin saturation
Blood film
3 symptoms of iron deficiency anaemia
Fatigue, Lethargy and dizziness
signs of iron deficiency anaemia
Pallor of mucous membranes
bounding pulse
systolic flow murmurs
smooth tongue , koilonychias
what are the 2 forms of macrocytic anaemia
Megaloblastic (low reticulocyte count, vit B/Folic acid deficiency or drug related ) No megaloblastic (alcoholism, hypothyroidism, liver disease..)
characteristics of megaloblastic changes of blood cells
RBC big and oval
neutrophils hyper segmented
Vitamin B12 is an essential co-factor for…
methylation in DNA and cell metabolism
Vitamin B12 absorption
requires presence of intrinsic factor (IF) for absorption in terminal ileum
where is Intrinsic factor made
parital cells in stomach
2 transport protein of Vit B12
Transcobalamin II and transcobalamin I
Some clinical consequence of Vit B12 deficiency
Brain: cognition, depression, psychosis Neurology: myelopathy, sensory changes, ataxia, spasticity (SACDC Infertility Cardiac cardiomyopathy Tongue: glossitis, taste impairment Blood : pancytopenia
what is pernicious anaemia
Autoimmune disorder
lack of IF
Lack of B12 absorption
gastric parietal cell antibodies or IF antibodies
