Red Cells

Question 1

normal red cell lifespan

Answer 1

12 days

Question 2

what are some substances necessary for red cell production?

Answer 2

iron

B12, folic acid

AAs

erythropoietin

Question 3

nature red blood cell

Answer 3

erythrocyte

Question 4

haemoglobin

Answer 4

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

Question 5

what is bilirubin?

Answer 5

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

Question 6

conjugated bilirubin is excreted where? what for?

Answer 6

into bile to help in food digestion

you get some excess in stool and urine

Question 7

congenital reduced red cell survival results in

Answer 7

haemolysis

Question 8

haemolysis

Answer 8

destruction or rupture of red blood cells

Question 9

G6DP deficiency

Answer 9

commonest causing enzymopathy in the world

signs: anaemia, neonatal jaundice, splenomegaly

Question 10

triggers to haemolysis in G6DP

Answer 10

broad beans

acute illness

infection

drugs

Question 11

Bohr effect gives what?

Answer 11

hypothermia

acidosis

Question 12

haemoglobin gas exchange:

Answer 12

O2 to tissues

CO2 to lungs

Question 13

difference between haemoglobin in sickle cell and normal:

Answer 13

Normal:
2 alpha chains
2 beta chains

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

Question 14

anaemia

Answer 14

either low RBC number

or low haemoglobin

(Hb below normal for age and sex)

Question 15

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

Answer 15

hypochromic microcytic

normochromic normocytic

macrocytic

Question 16

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

Answer 16

serum ferritin

Question 17

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

Answer 17

reticulocyte count

Question 18

how do you test to see if its macrocytic anaemia?

Answer 18

B12/ folate

bone marrow

Question 19

absorbed iron in the body is stored as

Answer 19

ferritin

Question 20

thalassaemia

Answer 20

mostly genetic

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

Question 21

what is the commonest cause of anaemia?

Answer 21

iron deficiency

Question 22

clinical features of iron deficiency

Answer 22

hypochromic microcytic red cells

kolinychia

atrophic tongue

angular cellulitis

Question 23

causes of iron deficiency

Answer 23

GI blood loss

menorrhagia

malabsorption (gastroectomy, coeliac disease)

diet

increased requirement (like in pregnancy)

Question 24

how do you manage iron deficiency?

correct the deficiency:

Answer 24

correct the deficiency:

oral Iron

IV iron if intolerant to oral

blood transfusion rare

Question 25

how do you manage iron deficiency? correct the cause:

Answer 25

diet ulcer therapy gynae interventions surgery

Question 26

if the reticulocyte count is INCREASED what does this show? | test for normochronic normocytic anaemia

Answer 26

acute blood loss haemolysis

Question 27

if the reticulocyte count is DECREASED/ NORMAL what does this show? (test for normochromic normocytic anaemia)

Answer 27

secondary anaemia hypoplasia marrow infiltration

Question 28

what is secondary anaemia?

Answer 28

anaemia of chronic disease

Question 29

underlying causes of secondary anaemia

Answer 29

infection inflammation malignancy

Question 30

haemolytic anaemia

Answer 30

accelerated RBC destruction - so a lower Hb | compensation by bone marrow - increased reticulocytes

Question 31

haemolysis can be acquired or congenital. Acquired is mostly

Answer 31

immune (extravascular) non-immune (intravascular)

Question 32

direct antiglobulin test detects what? | coombs test

Answer 32

immune haemolytic anaemia

Question 33

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

Answer 33

FBC, reticulocyte count, blood film serum bilirubin

Question 34

haemolytic anaemia. tests to find out the mechanism:

Answer 34

history and exam blood film direct antiglobulin test (coombs test)

Question 35

two types of macrocytic anaemia

Answer 35

non-megaloblastic megaloblastic

Question 36

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

Answer 36

pernicious anaemia

Question 37

what type of disease is pernicious anaemia?

Answer 37

auto immune

Question 38

mechanism behind pernicious anaemia:

Answer 38

either autoantibodies against intrinsic factor or gastric parietal cells! Dietary B12 binds to intrinsic factor (secreted by parietal cells) this B12/ IF complex then binds to receptors in the distal ileum and absorbs vitamin B12 therefore if B12 deficiency occurs

Question 39

how do you treat pernicious anaemia?

Answer 39

replace vitamin B12 IM injection Folate oral replacement

Question 40

folic acid deficiency in pregnancy can cause what?

Answer 40

neural tube defects (eg spina bifida) cleft palate

Question 41

what are the general anaemia symptoms?

Answer 41

tired/pallor breathlessness swelling of the ankles dizziness chest pain