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PHYSIO B1 > RBC 3 > Flashcards

RBC 3 Flashcards

1
Q

Define anaemia

A

a group of disorders in which either hemoglobin concentration of blood or/and RBC count is below the normal range for the age and sex.

Anaemia =Hb concentration is less than:
* 13 g/dL in adult males
* 11.5 g/dL in adult females
* 15 g/dL in newborn
* 9.5 g/dL at 3 months of age.

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2
Q

Classifications of Anaemia

A

Morphology (Wintrobe’s) classification:
Normocytic normochromic anaemias.
Macrocytic normochromic anaemia
Microcytic hypochromic anaemias

Etiological (Whitby’s) classification:
Deficiency Anemia
Haemolytic Anemia
Blood loss Anemia
Anemia due to chronic disease
Aplastic Anaemia

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3
Q

Common Anaemia 4

A

Iron- deficiency Anemia (IDA)
Hereditary Spherocytosis
Sickle Cell Anaemia
Thalassemia

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4
Q

Normocytic normochromic anaemias

A

Normal MCV (78–94μm3) & normal MCHC (30–38%)
* Acute post-haemorrhagic anaemia
* Haemolytic anaemias
* Aplastic anaemias.

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5
Q

Microcytic hypochromic anaemias

A

Reduced MCV (<78μm3) & reduced MCHC (<30%)
* Iron deficiency anaemia
* Chronic post-haemorrhagic
anaemia
* Thalassaemia.

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6
Q

Macrocytic normochromic anaemia

A

Increased MCV (>94μm3) & normal MCHC (30–38%)
* Megaloblastic anaemia due to deficiency of vitamin B12
* Megaloblastic anaemia due to
deficiency of folic acid.

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7
Q

Deficiency Anemia

A
  • Iron deficiency anaemia
  • Megaloblastic anaemia –Vitamin B12 or folic acid deficiency
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8
Q

Blood loss Anemia

A

Acute post- haemorrhagic anaemia(accidents)
Chronic post- haemorrhagic anaemia.

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9
Q

Haemolytic Anemia

A
  • Thalassemia
  • Sickle cell anaemia
  • Hereditary
    spherocytosis
  • G6PD deficiency
  • Microangiopathic
    haemolytic anaemia
  • Toxic effects(malaria, snake venom)
  • Splenomegaly
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10
Q

Aplastic Anaemia

A

It occurs due to the failure of bone marrow to produce RBCs

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11
Q

Anemia due to chronic disease

A
  • Tuberculosis * Chronic
    infections
  • Malignancies
  • Chronic lung diseases
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12
Q

Iron Deficiency Anaemia

A

Total Iron :4 to 5 grams
-65% in form of Hb.
-1% in form of heme compounds-promote intracellular oxidation.
4% in form of myoglobin.
0.1% is combined with protein transferrin in blood plasma.
15%−30% stored for later use, mainly in RES of bone marrow and liver parenchymal cells, principally in form of ferritin.

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13
Q

Causes of Iron Deficiency

A

Inadequate dietary intake of iron
Increased loss iron
Increased demand of iron
Decreased absorption of iron

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14
Q

Inadequate dietary intake of iron

A
  • Milk fed infants
  • Poor economic status
    individuals
  • Anorexia, e.g. in
    pregnancy
  • Elderly individuals due
    to atrophy and poor dentition.
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15
Q

increased loss iron

A
  • Menses
  • Acute blood loss
    -Hook worm infestation
    -Chronic blood loss
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16
Q

Increased demand of iron

A
  • Pregnancy
    -Rapid growth in infancy or adolescence
  • Erythropoietin therapy
17
Q

Decreased absorption of iron

A
  • Partial or total gastrectomy
  • Achlorhydria
  • Intestinal
    malabsorption diseases.
18
Q

Clinical Features of Iron Deficiency Anaemia

A

Symptoms
* irritability,palpitations,dizziness, breathlessness, headache and fatigue
* impair muscular performance, behavioral disturbances
Signs
* Pallor
* Nails: Flattening, Koilonychia
* Tongue: Soreness, Mild papillary
atrophy, Absence of filiform papillae
* Mouth : Angular stomatitis

19
Q

Blood Smear: Iron Deficiency Anaemia

A

look at pic pg 11

20
Q

Treatments of Iron Deficiency Anaemia

A

Oral
▪ Ferrous fumarate
▪ Ferrous gluconate

IV
-Sodium ferric gluconate
-Iron sucrose
-Iron dextran

Iron-Rich Diet
* Meat
* Poultry
* Fish
* Leafy greens
* Legumes

Blood Transfusion
* In Hb < 7–8 g/dL
* A unit of packed red cells increases the hemoglobin level by 1 g/dL

21
Q

Megaloblastic Anaemia

A

-presence of abnormally large developing red cells in the bone marrow
- based on ineffective erythropoiesis.

22
Q

Causes of Megaloblastic Anaemia

A

-Vitamin B12:Deficiency / abnormal metabolism
-Drugs interfering with synthesis of DNA
-Intrinsic Factor: Deficiency / defect
-Folate:Deficiency / abnormal metabolism / antifolate drug
-Arsenic poisoning
-Nitrous oxide inhalation

23
Q

Megaloblastic anaemia due to vitamin B12 deficiency

A

cause:
Inadequate dietary intake
Malabsorption of vitamin B12 by GIT System
result:
Pernicious anaemia- failure of secretion of intrinsic factor by the stomach

24
Q

Megaloblastic anaemia due to folate deficiency

A

Diet-Poor intake of vegetables

Increased demand in haemolysis & pregnancy

Malabsorption e.g. Coeliac disease

Drugs
* Certain anticonvulsants (e.g. phenytoin)
* Contraceptive pill
* Certain cytotoxic drugs (e.g. methotrexate)

25
Q

Clinical Features of Megaloblastic Anaemia

A

Symptoms
* Malaise (90%)
* Breathlessness (50%)
* Paranesthesia (80%)
* Sore mouth (20%)
* Weight loss
* Altered skin pigmentation
* Grey hair
* Impotence
* Poor memory
* Depression
* Personality change
* Hallucinations
* Visual disturbance
Signs
* Smooth tongue
* Angular cheilosis
* Vitiligo
* Skin pigmentation
* Heart failure
* Pyrexia

26
Q

Treatments of Megaloblastic Anaemia

A

Cobalamin
-Hydroxocobalamin is preferred because it is more highly protein- bound and therefore remains longer in the circulation (100–1000 mg)

Vitamin B12
-Oral doses of 1000 mg of vitamin B12 daily or injections to treat patients with pernicious anemia.

Folate
5-15mg; for 4 months

27
Q

Polycythemia

A

Increase in all cell types of blood, usually it represents increase in number of red cells

-Primary Polycythemia(Polycythemia vera)
Cause:
clonal neoplastic disorder of hematopoietic stem cells

-Secondary Polycythemia (Secondary erythrocytosis)
Cause:
due to appropriate or inappropriate increase in secretion of erythropoietin.

-Apparent (relative) polycythemia
Cause:
not true polycythemia, but a spurious increase in red cells due to dehydration

28
Q

Erythrocyte Sedimentation Rate (ESR)

A
  • Rate at which red cells sediment when an anticoagulated blood is allowed to stand in a vertical tube
  • Clinical significance – helps in understanding the prognosis of the disease.
  • Methods:
    ❖Westergren’s method.
    ❖ Wintrobe’ s method.

Normal Values
-In Westergren‘s method:
Males : 3–5 mm/hr
Females : 5–12 mm/hr
-In Wintrobe’s method:
Males : 0–9 mm/hr
Females : 0–20 mm/hr

29
Q

Factors Affecting ESR

A

-Rouleaux formation increases ESR
-Size of the red blood cells: Increase in ESR
-Number of red blood cells: When the number of RBCs increase the ESR
-Viscosity of blood: ESR is increased when the viscosity of blood is decreased

30
Q

Physiological Variation of ESR

A
  • Age: ESR is less in infants and old people.
  • Sex: ESR is greater in females (5–9 mm) than males (3–7 mm).
  • Pregnancy: ESR is raised in pregnancy from third month to parturition and returns to normal after 3–4 weeks of delivery
31
Q

Pathological Variation of ESR

A

Increases ESR
* Tuberculosis
* Malignant diseases
* Collagen diseases
* All anaemias
except sickle cell
anaemia
* Chronic infections.

Decreases ESR
* Polycythaemia
* Decreased fibrinogen levels
* Sickle cell anaemia
* Allergic conditions

32
Q

try practice SAQ

A

slide pg 24

PHYSIO B1 (19 decks)

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