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103: Theme 2 > Red Blood Cell Anaemia > Flashcards

Red Blood Cell Anaemia Flashcards

1
Q

What are the five Broad Causes of Anaemia

A
  • Bleeding- main one
  • Deficiency, iron, B12, folic acid
  • Haemolytic
  • Bone Marrow Dysfunction/ infiltration
  • poor O2 utilisation/loading
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2
Q

What is the Hb normal range for children?

A

110-160 g/L

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3
Q

What is the Hb normal range for Women?

A

115-165 g/L

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4
Q

What is the Hb normal range for pregnant women?

A

110-160 g/L

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5
Q

What is the Hb normal range for men?

A

130-180 g/L

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6
Q

What are four Clinical signs of Anaemia ?

A
  • Pallor, pale conjunctiva
  • Tachypnoea
  • Tachycardia
  • Koilonychia
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7
Q

What are the four diagnostic tests for Iron?

A
  • Serum Ferritin
  • Serum Iron
  • Serum Transferrin
  • % Transferrin Saturation
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8
Q

How many haemoglobin genes are there?

A
  • 4 alpha haemoglobin genes

- 2 beta haemoglobin genes

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9
Q

Symptoms of Anaemia

A
  • shortness of breath
  • headaches
  • tiredness
  • palpitations
  • pale conjunctiva
  • tachypnoea
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10
Q

Where are RBCs made ?

A
  • sternum
  • vertebrae
  • pelvis
  • femur
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11
Q

Requirements of Iron per day

A

1-2mg/day

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12
Q

Requirements of Vitamin B12

A

1-3mcg

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13
Q

Requirements of Folic Acid per day

A

100 mcg/day

- 4 times that amount in women

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14
Q

What are the four main diagnostic Iron tests

A
  • Serum Ferritin
  • Serum Iron, labile
  • Serum Transferrin
  • % Transferrin saturation
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15
Q

What is the function of transferrin?

A
  • carrier molecule of iron
  • increases if iron is deficient
  • similar to total iron binding capacity
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16
Q

What is the use of function of ferritin

A
  • storage form of iron
17
Q

What are the main causes of iron deficiency in the uk

A
  • bleeding via menstruation, occult GI malignancy
  • GI peptic ulcer
  • increased requirements
18
Q

Function of EPO

A

Erythropoietin

  • production of new RBC
  • levels are often higher when patient is anaemic
19
Q

What do Microcytic RBC indicate about the type of anaemia ?

A
  • Iron deficiency

- Inherited disorders of haemoglobin

20
Q

What do Macrocytic RBC indicate about the type of anaemia ?

A
  • B12 or folate deficient- production of nucleotides

- myelodysplasia

21
Q

What do Normocytic RBC indicate about the type of anaemia ?

A
  • aneamia of a chronic disease
  • acute haemorrhage
    Renal failure
22
Q

What are reticulocytes, and how are they useful in blood analysis ?

A
  • new RBC, still have their RNA within them- flow cytometry
  • ## indicates the rate of RBC production by the marrow
23
Q

What is a reticulocyte?

A

it is an erythrocyte (RBC) precursor, still contains mRNA

24
Q

What is the diameter of a red cell?

A

7-8 microns

25
Q

What would be seen under a blood film of megaloblastic bone marrow?

A
  • chromatin is out of phase with DNA replication

- very large megaloblasts

26
Q

What blood results would suggest acquired microcytic anaemia?

A
  • low ferritin
  • low Fe
  • high transferrin
  • low transferrin saturation
27
Q

What blood results would suggest inherited microcytic anaemia?

A
  • normal ferritin

- abnormal Hb electrophoresis/HPLC

28
Q

What are some causes of B12 autoimmune pernicious anaemia?

A
  • being vegan
  • gastric surgery
  • Crohn’s disease
  • lack of intrinsic factor- leading to inadequate absorption
29
Q

What are some causes of folate deficiency?

A
  • lack of folate in the diet
  • malabsorption (coeliac)
  • excess utilisation
30
Q

What would indicate anemia of a chronic disease?

A
  • normocytic cells
  • normal/ raised ferritin, normal/low transferrin
  • raised hepcidin and inflammatory proteins
31
Q

What are causes of anaemia of chronic disease?

A
  • Iron trapped inside macrophages
  • cancer
  • inflammation
  • rheumatoid arthritis
  • renal failure
32
Q

What would inidicate normocytic anemia due to renal failure?

A
  • lack of erythropoietin (low serum EPO )

- red cell horomone produced by kidney

33
Q

How could normocytic anemia due to renal failure be treated?

A
  • with weekly sc injections of recombinant EPO
34
Q

Describe inherited RBC membrane problems? - treatment

A
  • spherical red cells, not biconcave
  • e.g hereditary spherocytosis, hereditary elliptocytosis
  • a splenectomy can help
35
Q

How is haemoglobin analysed?

A
  • Hb electrophoresis
36
Q

What would be seen in a blood tests to indicate beta-thalassaemia?

A
  • microcytic hypochromic blood film

- low MCV

37
Q

Give examples of acquired immune red cell problems?

A
  • autoimmune: warm IgG vs. cold IgM

- Alloimmune: red cell transfusion reaction

38
Q

Give examples of acquired non-immune (red cell fragments) red cell problems?

A
  • mechanical heart valves can destroy RBC
  • DIC, very sick patients: spesis metastatic cancer
  • MAHA: microangiopathic haemolytic anaemia
39
Q

How can haemolysis be diagnosed?

A

high bilirubin levels
- patients are jaundiced, may need to check nails and mucous membranes

  • blood film to check for spherocytes
  • high LDH levels
  • high reticulocyte count
  • low haptoglobins

103: Theme 2 (8 decks)

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