PB1 Mess Flashcards
what do flecks of blood in stool mean
- this can mean that there is blood in the proximal part of the GIT
what is atrophic glossitis
Soreness, burning of the tongue with loss of taste buds
what does angualar stomatitis mean
- these are sores in the corner of the mouth
what are the cut of points of haemoglobin for anaemia for men and women
Hb <13.5g/dL(m) or <11.5g/dL(f) + MCV <80fL
what are the signs of microcytic anaemia caused by iron deficiency
- Fatigue,
- pica (craving non-food substances),
- koilonychia (spoon-shaped nails),
- hair loss,
- glossitis,
- angular stomatitis
What are the causes of iron deficiency
Decreased intake, decreased absorption, increased loss, increased requirements
Not an end diagnosis – must investigate cause
what is an alternative diagnosis of microcytic anaemia
thalassemia
what is adult haemoglobin made out of
2 alpha and 2 beta
why does low iron cause microcytic anaemia
- iron is needed to make heme - each globin molecules contains a heme moelcule which at its core containins an iorn moelcule
- iron deficiency means that this molecule does not form properly and therefore you generate a low haemoglobin (hypochromic haemoglobin)
how do you diagnose micoryctic anaemia
- history and clinical examination
- haemoglobin decreases and MCV decreases
- peripheral blood smear - this would show small pale red cells, pencil cells (iron deficiency)
how do you diagnose an iron deficiency
- Low serum iron
- increase in total iron binding capacity
- transferrin saturation is less than 16%
- serum ferrtin decreases
what is serum iron
Serum iron = the amount of iron circulating in the blood bound to transferrin (the iron carrying molecule).
what is total iron binding capacity
Total iron binding capacity = how much ‘room’ there is for iron to bind to transferrin. In iron deficiency anaemia, this is raised as a lot of the transferring is unbound.
what is transferrin sautraiotn
Transferrin saturation = the iron carrying molecule in blood. It is not saturated with iron in iron deficiency anaemia.
what is serum ferritin
Serum ferritin = the storage molecule for iron in the tissues
what is the management of microcytic anaemia caused by iron deficency
Oral iron (ferrous sulfate, ferrous gluconate, ferrous fumarate) - +/- asorbic acid for absorption
IV iron replacement
Investigate underlying cause
Patient 1 - colon cancer, diverticulitis etc.
what are the possible things that patient 1 has
- colon cancer
- diverticultiis
what does asorbic acid do for iron deficiency
Asorbic acid = increases the absorption of iron. Often recommended to take iron supplement with vitamin C containing foods e.g. orange juice
what is the proprable cause of patients 1 microcytic anaemia
Colon cancer = given the patient’s age, normal diet and history, her iron deficiency is probably due to increased iron (blood) loss from a colon cancer. It may be invading her colon wall and causing her to bleed, explaining the flecks of blood within the stool.
what are hypersegemented neutrophils
Neutrophils with 6 or more lobed-nuclei
- Neutrophils normally have 2-3 lobed nuclei
Characteristic of megaloblastic anaemia
how many lobes to normal neutrophils have
2-3 lobes
what is the difference between megalobasltic and non megaloblastic anaemia
megaloblastic anaemia
- this is microcytic anaemia that is caused due to the impairment of DNA syntehsis
non megaloblastic anaemia
- anamia forms just macrocytic
what is the haemoglobin and MCV in macrocytic anaemia
Hb <13.5g/dL(m) or <11.5g/dL(f) + MCV >96fL
what are the signs and symptoms of macrocytic anaemia
Shortness of breath
fatigue
palpitations - due to cardiovascular strain of providing enough oxygen to her tissues
pallor
bounding pulse- due to cardiovascular strain of providing enough oxygen to her tissues
