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haematology > Red Cells > Flashcards

Red Cells Flashcards

1
Q

normal red cell lifespan

A

12 days

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2
Q

what are some substances necessary for red cell production?

A

iron

B12, folic acid

AAs

erythropoietin

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3
Q

nature red blood cell

A

erythrocyte

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4
Q

haemoglobin

A

the iron-containing oxygen-transport metalloprotein in the red blood cell

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5
Q

what is bilirubin?

A

a product of haem degradation (which occurs in the spleen)

it gets transferred to the liver where it gets conjugated to make it more water soluble

then helps with digestion

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6
Q

conjugated bilirubin is excreted where? what for?

A

into bile to help in food digestion

you get some excess in stool and urine

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7
Q

congenital reduced red cell survival results in

A

haemolysis

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8
Q

haemolysis

A

destruction or rupture of red blood cells

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9
Q

G6DP deficiency

A

cells vulnerable to oxidative damage

commonest disease causing enzymopathy in the world

signs: anaemia, neonatal jaundice, splenomegaly, pigment gallstones

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10
Q

triggers to haemolysis in G6DP

A

broad beans

acute illness

infection

drugs

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11
Q

Bohr effect gives what?

A

hypothermia

acidosis

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12
Q

haemoglobin gas exchange:

A

O2 to tissues

CO2 to lungs

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13
Q

difference between haemoglobin in sickle cell and normal:

A

Normal:
2 alpha chains
2 beta chains

Sickle Cell:
2 alpha chains
2 beta (sickle) chains

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14
Q

anaemia

A

either low RBC number

or low haemoglobin

(Hb below normal for age and sex)

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15
Q

what are the 3 main types/ morphological descriptions of anaemia?

A

hypochromic microcytic

normochromic normocytic

macrocytic

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16
Q

how do you test to see if its hypochromic microcyctic anaemia?

A

serum ferritin

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17
Q

how do you test to see if its normochromic normocytic anaemia?

A

reticulocyte count

18
Q

how do you test to see if its macrocytic anaemia?

A

B12/ folate

bone marrow

19
Q

absorbed iron in the body is stored as

A

ferritin

20
Q

thalassaemia

A

mostly genetic

people make no or too little haemoglobin (absence or disfunction of alpha or beta chains in haemoglobin)

21
Q

what is the commonest cause of anaemia?

A

iron deficiency

22
Q

clinical features of iron deficiency

A

hypochromic microcytic red cells

kolinychia

atrophic tongue

angular cellulitis

23
Q

causes of iron deficiency

A

GI blood loss

menorrhagia

malabsorption (gastroectomy, coeliac disease)

diet

increased requirement (like in pregnancy)

24
Q

how do you manage iron deficiency?

A

correct the deficiency: oral/IV iron, blood transfusion

correct the cause: diet, ulcer therapy, gynae interventions, surgery

25
Q

if the reticulocyte count is INCREASED what does this show?

test for normochronic normocytic anaemia

A

acute blood loss

haemolysis

26
Q

if the reticulocyte count is DECREASED/ NORMAL what does this show?

(test for normochromic normocytic anaemia)

A

secondary anaemia

hypoplasia

marrow infiltration

27
Q

what is secondary anaemia?

A

anaemia of chronic disease

28
Q

underlying causes of secondary anaemia

A

infection

inflammation

malignancy

29
Q

haemolytic anaemia

A

accelerated RBC destruction - so a lower Hb

compensation by bone marrow - increased reticulocytes

30
Q

haemolysis can be acquired or congenital. Acquired is mostly

A

immune (extravascular)

non-immune (intravascular)

31
Q

direct antiglobulin test detects what?

coombs test

A

immune haemolytic anaemia

32
Q

haemolytic anaemia. tests to find out why is the patient haemolysing?

A

FBC, reticulocyte count, blood film

serum bilirubin

33
Q

haemolytic anaemia. tests to find out the mechanism:

A

history and exam

blood film

direct antiglobulin test (coombs test)

34
Q

two types of macrocytic anaemia

A

non-megaloblastic

megaloblastic

35
Q

what is the commonest cause of a B12 deficiency in the western world?

A

pernicious anaemia

36
Q

what type of disease is pernicious anaemia?

A

auto immune

37
Q

mechanism behind pernicious anaemia:

A

autoantibodies against:

  • intrinsic factor
  • or gastric parietal cells

malabsorption of dietary B12

(as dietary B12 binds to intrinsic factor secreted by parietal cells)

38
Q

how do you treat pernicious anaemia?

A

replace vitamin

B12 IM injection

Folate oral replacement

39
Q

folic acid deficiency in pregnancy can cause what?

A

neural tube defects (eg spina bifida)

cleft palate

40
Q

what are the general anaemia symptoms?

A

tired/pallor

breathlessness

swelling of the ankles

dizziness

chest pain

haematology (8 decks)

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