RBC

Question 1

What type of anemia is B12 deficiency? Name some possible causes

Answer 1

macrocytic megablastic anaemia

Crohn’s, coeliac, surgical removal of small bowel

Question 2

What cells are needed to absorb B12?

Answer 2

needs intrinsic factors from parietal cells

Question 3

What is anaemia?

Answer 3

reduced RBC mass, measured by Hb concentration

Question 4

What is haemolytic anaemia?

Answer 4

increased RBC and abnormal breakdown, autoimmune

Question 5

What is sickle cell disease?

Answer 5

increased reticulocytes. HbS mutation means that RBC become rigid and sickle when deoxygenated
HbS not HbA
autosomal recessive

Question 6

What are the symptoms and treatment of sickle cell disease?

Answer 6

bone and abdo pain, avascular necrosis
Treat - analgesia, transfusion and stem cell transplant
folic acid, penicillin, hydroxycarbonate

Question 7

What is microcytic anemia?

Answer 7

<76 fl - decreased Hb production

Question 8

What are some causes of microcytic anemia?

Answer 8

iron deficiency
thalassemia (autosomal recessive)
chronic disease

Question 9

What causes normocytic anaemia?

Answer 9

acute blood loss, chronic disease, combined haemnitic disease

Question 10

What is macrocytic anaemia and some causes?

Answer 10

> 96 fl - decreased synthesis of RBC

B12/folate deficency, alcohol excess/liver disease, hypothyroidism

Question 11

What are some triggers that could cause painful crisis in sickle cell anaemia?

Answer 11

cold, dehydration, infection, hypoxia

Question 12

Why do symptoms of sickle cell only show after 6 months?

Answer 12

drop in fetal Hb to adult Hb with mutation

Question 13

What happens with carriers of sickle cell?

Answer 13

Asymptomatic, apart from if exposed to hypoxia (e.g. aeroplanes)
protection against malaria falciparium

Question 14

How does hydroxyurea work to treat sickle cell anaemia?

Answer 14

increase HbF in RBC making them less likely to sickle

lowers number of neutrophils

Question 15

How would you test for sickle cell anaemia?

Answer 15

FBC
sickle solubility test
Hb electrophoresis
reticulocyte (raised)

Question 16

What dose of iron should you give for iron deficiency anaemia?

Answer 16

ferrous sulphate 200mg od

Question 17

What are some SE of oral iron?

Answer 17

abdo pain, bloating, dirrhoea

Question 18

What is pernicious anaemia?

Answer 18

autoimmune antibodies against parietal cells = B12 deficiency

Question 19

In which anaemias would you get pancytopenia?

Answer 19

folate and b12 deficiency anaemia (macrocytic)

Question 20

Which anaemia can cause neurological manifestations? Which symptoms?

Answer 20

vit b12 deficiency
peripheral neuropathy
dementia
sub acute combined degeneration of cord

Question 21

What is polycythaemia?

Answer 21

too many RBC or decreased plasma volume

Question 22

What are the main causes of polycythaemia?

Answer 22

primary cause is PRV (overactive bone marrow)

secondary causes e.g. dehydration

Question 23

What is thalaessaemia?

Answer 23

microcytic anaemic disease

genetic disorder causes decreased production of globin chains and decreased Hb

Question 24

How would test for thalaessaemia?

Answer 24

FBC, MCV, blood film (very pale RBC)

Question 25

How would you treat thalaessaemia?

Answer 25

lifestyle, folate supplements, transfusions

Question 26

How would you treat polycythaemia?

Answer 26

aspirin