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Ph: Pharmacology > Ph2: Haemotology > Flashcards

Ph2: Haemotology Flashcards

1
Q

What is Anaemia?

A

Anaemia is clinically low haemoglobin or red blood cell count in the blood.

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2
Q

What are the main symptoms of general anaemia and why?

A

Fatigue and weakness due to reduced oxygen supply to tissues.

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3
Q

What investigation should be performed for uninvestigated anaemia?

A

Full Blood Count (FBC) including Hb, Hct/PCV, MCV and RDW

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4
Q

What is the normal range of haemoglobin concentration in males and females?

A

135-180g/L in males
115-160g/L in females

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5
Q

What is MCV and what is the typical reference range?

A

Mean Corpuscular Volume and it is typically between 80-99fL

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6
Q

What is PCV and what is the typical reference range?

A

Packed Cell Volume and it is typically between 40-50%

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7
Q

What additional tests can be ordered for uninvestigated anaemia?

A

Reticulocyte Count, Reticulocyte Index, Lactate Dehydrogenase (LDH), Haptoglobin, Indirect Billirubin, Blood Smear.

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8
Q

What results would you see in haemolytic anaemia?

A

↑ Reticulocyte Count, ↑ Reticulocyte Index,
↑ LDH, ↑ Indirect Billirubin, ↓ Haptoglobin

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9
Q

What results would you see in underproductive anaemia?

A

↓/- Reticulocyte Count, ↓/- Reticulocyte Index, ↓ LDH, ↓ Indirect Billirubin, ↑/- Haptoglobin

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10
Q

What tests would you order for confirmed microcytic anaemia?

A

Iron Studies (Serum Fe, Ferritin, Transferrin/TIBC), Vitamin B12, Vitamin B9, Creatinine Concentration

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11
Q

How would you interpret the following?
↓ Serum Fe, ↓ Ferritin, ↑ TIBC,
- Vitamin B12, - Vitamin B9,
- Creatinine
BS shows: Hypochromic, Microcytic

A

Iron deficient anaemia

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12
Q

How would you interpret the following?
↓ Serum Fe, ↑ Ferritin, ↓ TIBC
- Vitamin B12, - Vitamin B9
- Creatinine
BS shows: Normochromic, Normocytic

A

Chronic inflammatory anaemia

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13
Q

How would you interpret the following?
- Serum Fe, - Ferritin, - TIBC
- Vitamin B12, - Vitamin B9
↑↑ Creatinine
BS shows: Normochromic, Normocytic

A

Anaemia of Chronic kidney disease

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14
Q

How would you interpret the following
↑ Serum Fe, ↑ Ferritin, ↓ TIBC
- Vitamin B12, - Vitamin B9
- Creatinine
BS shows: Microcytic, Hypochromic

A

Sideroblastic anaemia

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15
Q

What findings would you see in iron deficient anaemia on a blood smear?

A

Microcytic cells, Hypochromia, Pencil cells, Target cells

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16
Q

What findings would you see in a sideroblastic anaemia on a blood smear?

A

Microcytic cells, Hypochromia, Sideroblastic rings of iron on prussian blue staining

17
Q

Describe the pathology of sideroblastic anaemia and possible causes?

A

There is a dysfunction in the production of the porphyrin ring leading to decreased haemoglobin. Causes include lead poisoning, alcoholism and lead poisoning.

18
Q

Describe the pathology of anaemia of chronic inflammatory disease?

A

Body reduces available iron in bloodstream in case of bacterial infection. It increases ferritin storage and liver releases hepcidin which reduces iron absorption in GI

19
Q

What tool can be used to differentiate between iron deficient anaemia and thalassemia?

A

Mentzer’s Index
= MCV / RBCC
> 13 is iron deficient, < 13 is thalassemia

20
Q

When do the symptoms of alpha-thalassemia appear and why?

A

In uterine as alpha chains are involved in production of HbF (foetal).

21
Q

What clinical sign is seen in 4 deletion alpha-thalassemia and what does it suggest?

A

Hb-Barts (Tetrameres of gamma chains), it is a sign of Hydrops Fetalus and the baby will not make it to term.

22
Q

When do the symptoms of beta-thalassemia appear and why?

A

6-12 months after birth as the HbF (foetal) is replaced by HbA (adult) which contains beta chains.

23
Q

What is the standard investigation for diagnosis of thalassemia? What would you see in beta-thalassemia?

A

Haemoglobin electrophoresis
You would see ↓ HbA, ↑ HbF and ↑ HbA2 in beta-thalassemia

24
Q

What is the role of haptoglobin in the body?

A

Haptoglobin binds and removes free haemoglobin so a decrease in haptoglobin shows there is an increase in free haemoglobin

25
Q

What is the recommended dose of ferrous sulfate in treatment in IDA? How much elemental iron is the dose equal to?

A

200mg (PO) once daily
It is equal to 65mg of elemental iron

26
Q

How should iron supplementation be taken?

A

On an empty stomach with Vitamin C if possible. (Tablets or Orange juice)

27
Q

Describe the pathology of hereditary spherocytosis anameia?

A

There is a defect in the proteins that aid in erythrocyte structure (Anykrin and Spectrin) and this leads to non-flexible cells. These cannot pass through spleen and are heamolysed.

28
Q

What is hydrops foetalis

A

The accumulation of fluid in two or more compartments. This is due to foetus’ heart having to pump more and eventually failing leading to oedema.

Ph: Pharmacology (3 decks)

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