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Atrial fibrillation RCM:4 > Red cell disorders > Flashcards

Red cell disorders Flashcards

1
Q

What is the definition of anaemia

A

Reduced level of Hb (haemoglobin)

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2
Q

Symptoms of anaemia

A
  • Shortness of breath
  • Weakness/lethargy
  • Tachycardia (high resting heart rate)
  • Glossitis (painful red tongue) and angular cheilitis (fissures at corner of mouth)
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3
Q

What is not a reliable sign of anaemia vs what is

A

Skin colour is not reliable

-Instead check nail bed and conjunctiva (they may be pale)

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4
Q

What may severe anaemia in elderly patients cause

A

Angina

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5
Q

What may be more elevated in RBCs in those with anaemia

A

DPG so O2 is more readily given up to tissues

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6
Q

What is iron deficiency anaemia

A

Microcytic (decreased MCV) which means that the mean corpuscular volume is reduced of red blood cells

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7
Q

In what ways can you decrease input to cause iron deficiency anaemia

A

Poor diet

Surgical removal of stomach

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8
Q

In what ways can you increase output to cause iron deficiency anaemia

A

Menstruation

Gastrointestinal bleeding ulcers which may be caused by the use of NSAIDs (eg ibuprofen)

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9
Q

IN what ways can you increase demand to increase iron deficiency anaemia

A

Pregnancy

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10
Q

What is the main cause of iron deficiency

A

Increased output (eg menstruation)

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11
Q

Difference between acute vs chronic bleeding

A

Acute- Over time, there is haemodilution by the addition of water

chronic- long term bleeding ie menstruation and there is no haemodilution

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12
Q

How to treat iron deficiency anaemia (not in pregnancy)

A

Find the underlying cause (eg menstruation or GI tract bleeding)

  • Give oral iron (FeSO4)
  • sometimes a transfusion
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13
Q

How to treat iron deficiency anaemia in pregnant women

A

Prophylaxis (oral iron) with folic acid

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14
Q

What is normocytic anaemia

A

Normal sized red blood cells, but a low number of red blood cells

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15
Q

What leads to normocytic anaemia

A

Renal anaemia

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16
Q

How do you treat renal anaemia

A

Fe and EPO

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17
Q

What type of anaemia could there be in pregnancy

A

Iron deficiency

Normocytic

18
Q

Why could there be normocytic anaemia in pregnancy

A

Pregnancy increases MCV but iron deficiency decreases MCV so they could cancel out. This means the anaemia may be normocytic instead

19
Q

What is megaloblastic anaemia

A

Macrocytic anaemia (abnormally large red blood cells called megaloblasts found in bone marrow)

20
Q

Why is there abnormal red blood cell maturation (causes megaloblastic anaemia)

A

Due to defective DNA synthesis (due to vitamin b12 or folate deficiency)

21
Q

What is B12 used as

A

A cofactor for purine and pyrimidine synthesis (therefore cell division)

22
Q

What does B12 require for absorption

A

Intrinsic factor

23
Q

What can a microcytic but not anaemic patient mean

A

Evidence of alcohol abuse

24
Q

What can megaloblastic anaemia lead to

A

Haemolytic anaemia

25
Q

In DNA synthesis, what is folic acid used as

A

A building block

26
Q

What in DNA synthesis is used as a drug target

A

DHF reductase which is involved in DNA synthesis

27
Q

What drug inhibits DHF

A

Methotrexate (so used to prevent DNA synthesis and so is used as an anti-cancer drug)

28
Q

What complication does methotrexate cause and how to solve this

A

Stops Folate regeneration so this is treated with folonic acid

29
Q

What do haemolytic anaemias do

A

Increased rate of RBC destruction

30
Q

Two different types of haemolytic anaemias

A

Spherocytosis- genetic

Acquired

31
Q

What is spherocytosis

A

Abnormal reduction in RBC membrane protein and so cells become fragile

32
Q

Why might there be a folate deficiency and what are the symptoms of this

A

Due to increased erythropoiesis (blood cell formation)

-Jaundice and enlarged spleen (because that’s the site of red cell destruction)

33
Q

What does sickle cell anaemia cause

A

Haemolytic anaemia

34
Q

What causes thalassaemias and what Is it

A

Genetics

People with thalassaemia produce either no or too little haemoglobin

35
Q

What is aplastic anaemia

A

Insufficient production of RBCs, WBCs and platelets (pancytopenia)

36
Q

What causes aplastic anaemia

A
  • Viral, radiation or drugs
  • Cytotoxic agents (anticancer)
  • Chloramphenicol
  • INsecticides
37
Q

How is aplastic anaemia treated

A
  • Bone marrow transplant
  • Immunosuppressants to prevent destruction of stem cells
  • COlony-stimulating factors which increase white blood cell count
38
Q

What is polycythaemia

A

Increased haemoglobin content and haematocrit

39
Q

Symptoms of polycythaemia

A
  • HEadaches
  • Blurred vision
  • HYpertension
  • Cyanosis (blue skin) caused by sluggish blood flow
40
Q

What is polycythaemia caused by (primary and secondary)

A

primary- changes in bone marrow, stem cell defect

secondary- increased erythropoietin (stimulates stem cells to turn into red blood cells) which is increased due to altitude, smoking and renal carcinomas

41
Q

Treatment of primary polycythaemia

A
  • Bleeding the patient

- Radioactive phosphorus (myelosuppression which is suppression of bone marrow)

Atrial fibrillation RCM:4 (12 decks)

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