Nutritional Anaemia

Question 1

What is anaemia

Answer 1

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.

Question 2

what are the 2 things needed for DNA synthesis of red blood cells

Answer 2

Vitamin B12 and Folic acid

Question 3

what is needed for Haemoglobin synthesis

Answer 3

Iron

Question 4

3 ways anaemia can occur

Answer 4

Failure of production
ineffective erythropoiesis
decreased survival

Question 5

3 causes of microcytic anaemia

Answer 5

Iron deficiency
Thalassemia
Anaemia of chronic disease

Question 6

5 causes of normocytic anaemia

Answer 6

Anaemia chronic disease 
aplastic anaemia
chronic renal failure 
bone marrow infiltration 
sickle cell disease

Question 7

6 causes of macrocytic

Answer 7

B12 deficiency/ folate deficiency 
Myelodysplasia
Alcohol induced 
drug induced 
liver disease 
myxoedema

Question 8

what is the name of the protein used to transport iron

Answer 8

transferrin

Question 9

2 storage proteins of iron and where is it found

Answer 9

ferritin and hemosiderin

found in cells of liver, spleen and bone marrow

Question 10

how is iron absorption regulated

Answer 10

by GI mucosal cells and hepcidin

Question 11

where is iron absorbed from

Answer 11

duodenum and proximal jejunun

Question 12

how is iron absorbed

Answer 12

via ferroportin receptors on enterocytes

Question 13

what does hepcidin do

Answer 13

cause ferroportin internalisation and degradation, thereby decreasing iron transfer into blood plasma from the duodenum

Question 14

Main clue for iron deficiency

Answer 14

Low ferritin

Question 15

Iron deficiency investigation

Answer 15

FBC: Hb, MCV, MCH, Reticulocyte count
Iron studies: Ferritin, Transferrin saturation
Blood film

Question 16

3 symptoms of iron deficiency anaemia

Answer 16

Fatigue, Lethargy and dizziness

Question 17

signs of iron deficiency anaemia

Answer 17

Pallor of mucous membranes
bounding pulse
systolic flow murmurs
smooth tongue , koilonychias

Question 18

what are the 2 forms of macrocytic anaemia

Answer 18

Megaloblastic (low reticulocyte count, vit B/Folic acid deficiency or drug related )
No megaloblastic (alcoholism, hypothyroidism, liver disease..)

Question 19

characteristics of megaloblastic changes of blood cells

Answer 19

RBC big and oval

neutrophils hyper segmented

Question 20

Vitamin B12 is an essential co-factor for…

Answer 20

methylation in DNA and cell metabolism

Question 21

Vitamin B12 absorption

Answer 21

requires presence of intrinsic factor (IF) for absorption in terminal ileum

Question 22

where is Intrinsic factor made

Answer 22

parital cells in stomach

Question 23

2 transport protein of Vit B12

Answer 23

Transcobalamin II and transcobalamin I

Question 24

Some clinical consequence of Vit B12 deficiency

Answer 24

Brain: cognition, depression, psychosis
Neurology: myelopathy, sensory changes, ataxia, spasticity (SACDC
Infertility
Cardiac cardiomyopathy
Tongue: glossitis, taste impairment
Blood : pancytopenia

Question 25

what is pernicious anaemia

Answer 25

Autoimmune disorder
lack of IF
Lack of B12 absorption
gastric parietal cell antibodies or IF antibodies