Red Cells 2 Flashcards
How is the normal range of something derived?
- Subjects who don’t have disease
- Normal distribution
- Mean +/-2 standard deviations
What are some factors that influence the normal range?
- Age
- Sex
- Ethnic origin
- Time of day sample taken
- Time to analyse
What are the reference ranges for Hb?
- Male 12-70
- 140-180
- Male >12
- 116-156
- Female 12-70
- 120-160
- Female >70
- 108-143
Describe the clinical features of anaemia?
- Tiredness
- Breathlessness
- Swelling of ankles
- Dizziness
- Chest pain
What does the presentation of anaemia depend on?
- Age, speed of onset, and Hb level
What are some potential clinical features of anaemia that could be related to the underlying cause?
- Evidence of bleeding
- Menorrhagia
- Dyspepsia, PR bleeding
- Symptoms of malabsorption
- Diarrhoea
- Weight loss
- Jaundice
- Splenomegaly/lymphadenopathy
Describe the approach to determining the cause of anaemia?
Can be due to:
- bone marrow
- red cell
- destruction/loss
![](https://s3.amazonaws.com/brainscape-prod/system/cm/371/253/982/a_image_thumb.png?1609785857)
Describe the aetiology of anaemia due to bone marrow problems?
Cellularity
Stroma
Nutrients
Describe the aetiology of anaemia due to red cell problems?
Membrane
Haemoglobin
Enzymes
Describe the aetiology of anaemia due to destruction/loss?
Blood loss
Haemolysis
Hypersplenism
What does MCH stand for?
Mean cell haemoglobin
What does MCV stand for?
Mean cell volume (cell size)
What are red cell indices?
Calculations that provide information on the physical characteristics of RBCs
- Automated measurement of red cell size and haemoglobin content
- MCH = mean cell haemoglobin
- MCV = mean cell volume (cell size)
- Gives morphological description of anaemia and clue to cause
What are the 3 morphological describers for anaemic cells?
- Hypochromic microcytic anaemia
- Small, pale cells
- Normochromic normocytic anaemia
- Normal size and normal haemoglobin content in average cell
- Macrocytic anaemia
- Big, red cells
What do the cells look like in hypochromic microcytic anaemia?
Small, pale cells
What do the cells look like in normochromic normocytic anaemia?
- Normal size and normal haemoglobin content in average cell
What do the cells look like in macrocytic anaemia?
- Big, red cells
For each morphological describer of the cells in anaemia, what follow up investigations should be done?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/371/253/994/a_image_thumb.png?1609786136)
Describe the investigations for anaemia?
Red cell indices and blood film
Then depending on the morphology of cells (look at picture)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/371/253/996/a_image_thumb.png?1609786172)
Describe the aetiology of hypochromic microcytic anaemia?
Low serum ferritin - iron deficiency
Normal/increased serum ferritin - thalassaemia, secondary anaemia
![](https://s3.amazonaws.com/brainscape-prod/system/cm/371/253/997/a_image_thumb.png?1609786251)
Where is iron absorbed?
Absorbed in duodenam (Fe2 better than Fe3)
Describe the process of iron being absorbed?
- Bound to mucosal ferritin and sloughed off
- Or transported across the basement membrane by ferroportin
- Then bound to transferrin in plasma
- Stored as ferritin – mainly in liver