- shortness of breath - headaches - tiredness - palpitations - pale conjunctiva - tachypnoea

Red Blood Cell Anaemia Flashcards by A.M.C.T Kate

What are the five Broad Causes of Anaemia

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

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What is the Hb normal range for children?

110-160 g/L

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What is the Hb normal range for Women?

115-165 g/L

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What is the Hb normal range for pregnant women?

110-160 g/L

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What is the Hb normal range for men?

130-180 g/L

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What are four Clinical signs of Anaemia ?

Pallor, pale conjunctiva
Tachypnoea
Tachycardia
Koilonychia

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What are the four diagnostic tests for Iron?

Serum Ferritin
Serum Iron
Serum Transferrin
% Transferrin Saturation

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How many haemoglobin genes are there?

4 alpha haemoglobin genes

- 2 beta haemoglobin genes

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Symptoms of Anaemia

shortness of breath
headaches
tiredness
palpitations
pale conjunctiva
tachypnoea

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Where are RBCs made ?

sternum
vertebrae
pelvis
femur

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Requirements of Iron per day

1-2mg/day

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Requirements of Vitamin B12

1-3mcg

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Requirements of Folic Acid per day

100 mcg/day

- 4 times that amount in women

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What are the four main diagnostic Iron tests

Serum Ferritin
Serum Iron, labile
Serum Transferrin
% Transferrin saturation

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What is the function of transferrin?

carrier molecule of iron
increases if iron is deficient
similar to total iron binding capacity

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What is the use of function of ferritin

storage form of iron

What are the main causes of iron deficiency in the uk

bleeding via menstruation, occult GI malignancy
GI peptic ulcer
increased requirements

Function of EPO

Erythropoietin

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

What do Microcytic RBC indicate about the type of anaemia ?

Iron deficiency

- Inherited disorders of haemoglobin

What do Macrocytic RBC indicate about the type of anaemia ?

B12 or folate deficient- production of nucleotides

- myelodysplasia

What do Normocytic RBC indicate about the type of anaemia ?

aneamia of a chronic disease
acute haemorrhage
Renal failure

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

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

What is a reticulocyte?

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

What is the diameter of a red cell?

7-8 microns

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

- chromatin is out of phase with DNA replication | - very large megaloblasts

What blood results would suggest acquired microcytic anaemia?

- low ferritin - low Fe - high transferrin - low transferrin saturation

What blood results would suggest inherited microcytic anaemia?

- normal ferritin | - abnormal Hb electrophoresis/HPLC

What are some causes of B12 autoimmune pernicious anaemia?

- being vegan - gastric surgery - Crohn's disease - lack of intrinsic factor- leading to inadequate absorption

What are some causes of folate deficiency?

- lack of folate in the diet - malabsorption (coeliac) - excess utilisation

What would indicate anemia of a chronic disease?

- normocytic cells - normal/ raised ferritin, normal/low transferrin - raised hepcidin and inflammatory proteins

What are causes of anaemia of chronic disease?

- Iron trapped inside macrophages - cancer - inflammation - rheumatoid arthritis - renal failure

What would inidicate normocytic anemia due to renal failure?

- lack of erythropoietin (low serum EPO ) | - red cell horomone produced by kidney

How could normocytic anemia due to renal failure be treated?

- with weekly sc injections of recombinant EPO

Describe inherited RBC membrane problems? - treatment

- spherical red cells, not biconcave - e.g hereditary spherocytosis, hereditary elliptocytosis - a splenectomy can help

How is haemoglobin analysed?

- Hb electrophoresis

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

- microcytic hypochromic blood film | - low MCV

Give examples of acquired immune red cell problems?

- autoimmune: warm IgG vs. cold IgM | - Alloimmune: red cell transfusion reaction

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

- mechanical heart valves can destroy RBC - DIC, very sick patients: spesis metastatic cancer - MAHA: microangiopathic haemolytic anaemia

How can haemolysis be diagnosed?

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