Nutritional Anaemia Flashcards

1
Q

What is anaemia

A

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.

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2
Q

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

A

Vitamin B12 and Folic acid

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3
Q

what is needed for Haemoglobin synthesis

A

Iron

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4
Q

3 ways anaemia can occur

A

Failure of production
ineffective erythropoiesis
decreased survival

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5
Q

3 causes of microcytic anaemia

A

Iron deficiency
Thalassemia
Anaemia of chronic disease

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6
Q

5 causes of normocytic anaemia

A
Anaemia chronic disease 
aplastic anaemia
chronic renal failure 
bone marrow infiltration 
sickle cell disease
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7
Q

6 causes of macrocytic

A
B12 deficiency/ folate deficiency 
Myelodysplasia
Alcohol induced 
drug induced 
liver disease 
myxoedema
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8
Q

what is the name of the protein used to transport iron

A

transferrin

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9
Q

2 storage proteins of iron and where is it found

A

ferritin and hemosiderin

found in cells of liver, spleen and bone marrow

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10
Q

how is iron absorption regulated

A

by GI mucosal cells and hepcidin

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11
Q

where is iron absorbed from

A

duodenum and proximal jejunun

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12
Q

how is iron absorbed

A

via ferroportin receptors on enterocytes

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13
Q

what does hepcidin do

A

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

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14
Q

Main clue for iron deficiency

A

Low ferritin

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15
Q

Iron deficiency investigation

A

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

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16
Q

3 symptoms of iron deficiency anaemia

A

Fatigue, Lethargy and dizziness

17
Q

signs of iron deficiency anaemia

A

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

18
Q

what are the 2 forms of macrocytic anaemia

A
Megaloblastic (low reticulocyte count, vit B/Folic acid deficiency or drug related )
No megaloblastic (alcoholism, hypothyroidism, liver disease..)
19
Q

characteristics of megaloblastic changes of blood cells

A

RBC big and oval

neutrophils hyper segmented

20
Q

Vitamin B12 is an essential co-factor for…

A

methylation in DNA and cell metabolism

21
Q

Vitamin B12 absorption

A

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

22
Q

where is Intrinsic factor made

A

parital cells in stomach

23
Q

2 transport protein of Vit B12

A

Transcobalamin II and transcobalamin I

24
Q

Some clinical consequence of Vit B12 deficiency

A
Brain: cognition, depression, psychosis
Neurology: myelopathy, sensory changes, ataxia, spasticity (SACDC
Infertility
Cardiac cardiomyopathy
Tongue: glossitis, taste impairment
Blood : pancytopenia
25
Q

what is pernicious anaemia

A

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