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Haematology and immunology > Red blood cells 2 > Flashcards

Red blood cells 2 Flashcards

1
Q

What is normal haemoglobin for males aged 12-70?

A

140-180

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2
Q

What is normal haemoglobin for males >70 years?

A

116-156

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3
Q

What is normal haemoglobin for females aged 12-70?

A

120-160

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4
Q

What is normal haemoglobin for females >70 years?

A

108-143

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5
Q

What are general anaemia features?

A 
Tiredness
Pallor
Breathlessness
Ankle swelling
Dizziness
Chest pain
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6
Q

What factors affect anaemia symptoms?

A

Age
Speed of onset
Haemoglobin level

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7
Q

What symptoms will anaemic patients get if underlying cause is bleeding?

A

Menorrhagia
Dyspepsia
Post rectal bleeding

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8
Q

What symptoms will anaemic patients get if the underlying cause is malabsorption?

A

Diarrhoea

Weight loss

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9
Q

What is it called when patient doesn’t produce red cells?

A

Aplastic anaemia

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10
Q

What are 3 general areas anaemia can happen?

A

Bone marrow - cell production
Red cell during life
Cell destruction

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11
Q

How do we get a morphological description of red cells?

A

Mean cell haemoglobin

Mean cell volume

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12
Q

How can cells be described morphologically?

A 
Hypochromic - low haemoglobin
Microcytic - small cells
Normochromic
Normocytic
Macrocytic
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13
Q

What are the 3 broad types of anaemia?

A

Hypochromic microcytic anaemia
Normochromic normocytic anaemia
Macrocytic anaemia

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14
Q

What investigation should be done intitially?

A

Red cell indices - MCV, MCH

Blood film

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15
Q

What investigation should be done if hypochromic microcytic anaemia?

A

Serum ferritin

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16
Q

What investigation should be done if normochromic normocytic anaemia?

A

Reticulocyte count

17
Q

What investigation should be done if macrocytic anaemia?

A

B12/folate

Bone marrow

18
Q

What would you see in a reticulocyte count of someone with dysfunctioning bone marrow?

A

Low reticulocyte count

19
Q

What happens if serum ferritin is normal or increased in hypochormic microcytic anaemia?

A

Tahlassaemia

Secondary anaemia

20
Q

What happens to ferritin in inflammation and why is this important?

A

Increases - can mask iron deficiency anaemia in conditions such as rheumatoid arthritis

21
Q

What is common on history of iron deficiency anaemia?

A

Dyspepsia/GI bleeding
Other bleeding - menorrhagia
Low iron in diet
Increased requirement ie pregnancy

22
Q

What are clinical features of iron deficiency?

A

Koilonychia
Atrophic tongue
Angular stomatitis
Hypochromitic microcytic cells

23
Q

What are causes of iron deficiency?

A

GI blood loss
Menorrhagia
Malabsorption

24
Q

How is iron deficiency managed?

A

Oral iron usually sufficient
IV iron if intolerant of oral
Blood transfusion rarely indicated
Correct the cause

25
Q

What are causes of increases reticulocyte count?

A

Acute blood loss

Haemolysis

26
Q

What are causes of low reticular count?

A

Secondary anaemia
Hypoplasia
Marrow infiltration

27
Q

What is secondary anaemia?

A

Anaemia of chronic disease

28
Q

What is haemolytic anaemia?

A

Accelerated red cell destruction to the point it can’t be compensated by bone marrow reticular cell production

29
Q

What does the direct antiglobulin test do?

A

Detects presence of complement fixed on red cell

30
Q

How does antiglobulin test happen?

A

Put anti-antibody-antibodies into blood, if antibodies present on antigens of blood blood will clump

31
Q

What does it mean if someone has haemolytic anaemia with a positive direct antiglobulin test?

A

It is immune mediated

32
Q

What investigations should be done if you suspect patient is haemolysing?

A 
FBC
Reticulocyte count - raised
Blood film
Serum billirubin
Serum haptoglobin
33
Q

What are causes of folate deficiency?

A

Dietary
Increased requirements
GI pathology ie coeliac disease

34
Q

What are physical features of macrocytic anaemia

A

Lemon-yellow tinge
Bilirubin, LDH
Red cells friable

35
Q

How is folate deficiency treated?

A

Oral folate replacement

Ensure B12 normal if neuropathic symptoms

36
Q

What are other causes of macrocytosis?

A 
Alcohol
Drugs - methotrexate, antiretrovirals, hydroxycarbamide
Disordered liver function
Hypothyroidism
Myelodysplasia

Haematology and immunology (19 decks)

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