Nutritional anaemias

Question 1

What is anaemia?

Answer 1

= condition in which the number of red blood cells and therefore oxygen-carrying capacity is insufficient to meet body’s physiological needs

• Reduction in haemoglobin

Question 2

What does the red blood cells require to mature?

Answer 2

• VITAMIN B12 and folic acid for DNA synthesis
• Iron for haemoglobin synthesis
• Vitamins
• Cytokines
• Healthy bone marrow environment

Question 3

Why would you not have enough haemoglobin?

Answer 3

• Failure of production - hypo proliferation, low level of reticulocytes (baby red blood cells)
• Ineffective erythropoiesis
• Decreased survival - blood loss, haemolysis

Question 4

What is MCV?

Answer 4

= Mean cell volumes

Shows average size of red blood cells:

• Microcytic - small
• Normocytic - normal
• Macrocytic - big

Question 5

What is nutrional anaemias?

Answer 5

= anaemia caused by lack of essential ingredients that the body acquires from food sources

Question 6

Why do we need iron as humans?

Answer 6

Iron needed for oxygen transport

Needed for erythropoiesis varying on the body size and gender

75% of iron comes from food sources - meat and seafood

Need significant more during pregnancy

Regulation is at the stage where you absorb it

Used in storage and transport proteins (ferritin and haemosiderin)

Question 7

How is iron absorbed, regulated and transported?

Answer 7

Iron absorption: regulated by GI mucosal cells, iron binds to plasma and transferrin

• Amount absorbed depends on type ingested

Hepcidin = iron regulation hormone

• Causes ferroprotein internalisation and degradation
• Decreasing iron transfer into blood plasma from the duodenum

Iron transported from enterocytes then enter plasma (or stored as ferritin) and transported to bone marrow

Question 8

What is a iron deficiency?

Answer 8

Reduced ferritin stores and increased transferrin

Causes:

• Not enough in diet
• Malabsorption
• Increased physiological needs
• Loosing too much in blood

Question 9

What is B12 and folate deficiency?

Answer 9

Both important for final maturation of RBC and synthesis of DNA

Results In macrocytic anaemia - low Hb and high MCV

• Megaloblastic - low reticulocyte count
• Non-megaloblastic

Vitamin B12 requires the Prescence of intrinsic factor (made in stomach) for absorption in terminal ileum

Question 10

What are the causes of folate deficiency?

Answer 10

Question 11

What are the causes of B12 deficiency?

Answer 11

Question 12

What is pernicious anaemia?

Answer 12

• Autoimmune disorder
• Lack of intrinsic factor
• Lack of B12 absorption

Question 13

How do you work out from a full blood count what type of anemia a patient might have?

Answer 13