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MEDI2011 > Week 1 - Anaemia > Flashcards

Week 1 - Anaemia Flashcards

1
Q

Microcytic anaemia is associated with which conditions?

A

Iron deficiency, thalassemia, chronic disease, sideroblastic

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2
Q

Normocytic anaemia is associated with which conditions?

A

Infections, inflammatory disease, aplastic anaemia, malignancy, haemorrhage

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3
Q

Macrocytic anaemia is associated with which conditions?

A

Megaloblastic - B12/folate deficiency

Non-megaloblastic - alcohol, liver disease, hypothyroidism, pregnancy

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4
Q

Normochromic anaemia is associated with which conditions?

A

Chronic disease, haemorrhage, B12/folate deficiency

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5
Q

Hypochromic anaemia is associated with which conditions?

A

Iron deficiency, thalassaemia

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6
Q

Poikilocytosis

A

Abnormal shape

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7
Q

Polycythaemia and examples

A

High RBCs/PCV

May be myeloproliferative syndrome, reaction to chronically low oxygen, malignancy (rarely)

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8
Q

What is the most common cause of anaemia world-wide?

A

Iron deficiency

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9
Q

What is the most common type of anaemia found in hospitalised patients?

A

Anaemia of chronic disease

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10
Q

Mechanism for anaemia in its with chronic renal disease?

A

Decreased erythropoietin production

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11
Q

Describe the biochemical abnormality underlying megaloblastic anaemia

A

Low levels of folic acid or vitamin B12 impair one-carbon transfer important in the production of folate, polyglutamates and the generation of pyrimidines

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12
Q

Maternal folate deficiency is associated with what condition in the infant?

A

Spina bifida

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13
Q

What is evidence of increased erythropoietic activity?

A

Elevated reticulocyte count in peripheral blood

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14
Q

67yo male, non-megaloblastic anaemia, normal reticulocyte count. Likely cause?

A

Alcohol abuse

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15
Q

43yo female, several months of increasing lethargy, weight gain, constipation, hoarse voice, dry skin. HR 48bpm, anaemia. What do you expect to find in blood test?

A

Non-megaloblastic macrocytic anaemia and elevated TSH

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16
Q

What are megaloblasts?

A

Immature erythrocytes. Large than normal red cells and nucleated.

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17
Q

What does the presence of megaloblasts indicate about the underlying pathophysiogenic mechanism?

A

Impaired DNA production –> B12/folate deficiency. Cell growth continues during the delay in progression through the normal cell division cycle.

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18
Q

Symptoms of B12 or folate deficiency

A

Megaloblasts
Neurological: ataxia, impaired sensory perception, parasthesiae, mental disorder e.g. mood disorders, psychosis; cognitive disorders e.g. poor concentration, poor memory, dementia etc
GIT: symptoms of atrophic gastritis or chronic pancreatitis, malabsorption e.g. non-specific abdominal discomfort or pain, bloating, bowel disturbances
Other symptoms of auto-immune disease e.g. vitiligo

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19
Q

Briefly outline the production of erythrocytes

A

proerythroblast –> erythroblast –> reticulocyte –> Erythrocyte

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20
Q

Briefly outline the production of platelets

A

megakaryoblast –> promegakaryocyte –> megakaryocyte –> platelet

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21
Q

Briefly outline the production of basophils, neutrophils and eosinophils

A

myeloblast –> B/N/E. Promyelocyte –> Myelocyte –> Metamyelocyte –> Band –> basophil/neutrophil/eosinophil

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22
Q

Briefly outline the production of macrophages

A

Myeloblast –> monoblast –> promonocyte –> monocyte –> macrophage

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23
Q

Outline sites at which haemopoiesis occurs and how this changes from the fetus to the adult

A 
Fetus: 0-2 months: yolk sac
2-7 months: liver and spleen
5-9 months: bone and marrow
Infant: bone marrow, most bones
Adult: vertebrae, ribs, sternum, skull, sacrum, pelvis, proximal femur
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24
Q

What condition causes normochromic, normocytic anaemia, normal TIBC and ferritin?

A

Chronic disease

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25
Q

What condition causes microcytic, hypochromic anaemia, increased TIBC, low ferritin, poikilocytosis?

A

Iron deficiency

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26
Q

What condition causes normochromic, macrocytic anaemia, decreased TIBC, increased ferritin?

A

Chronic liver disease

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27
Q

What condition causes normochromic, normocytic anaemia with increased reticulocytes?

A

Haemolysis

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28
Q

What condition causes normochromic, normocytic anaemia with reduced reticulocytes?

A

Myelodysplasia

29
Q

Describe the biochemical abnormality underlying megaloblastic anaemia

A

Low levels of folic acid or vitamin B12 impair one-carbon transfer important in the production of folate, polyglutamates and the generation of pyrimidines

30
Q

Maternal folate deficiency is associated with what condition in the infant?

A

Spina bifida

31
Q

What is evidence of increased erythropoietic activity?

A

Elevated reticulocyte count in peripheral blood

32
Q

67yo male, non-megaloblastic anaemia, normal reticulocyte count. Likely cause?

A

Alcohol abuse

33
Q

43yo female, several months of increasing lethargy, weight gain, constipation, hoarse voice, dry skin. HR 48bpm, anaemia. What do you expect to find in blood test?

A

Non-megaloblastic macrocytic anaemia and elevated TSH

34
Q

What are megaloblasts?

A

Immature erythrocytes. Large than normal red cells and nucleated.

35
Q

What does the presence of megaloblasts indicate about the underlying pathophysiogenic mechanism?

A

Impaired DNA production –> B12/folate deficiency. Cell growth continues during the delay in progression through the normal cell division cycle.

36
Q

Symptoms of B12 or folate deficiency

A

Megaloblasts
Neurological: ataxia, impaired sensory perception, parasthesiae, mental disorder e.g. mood disorders, psychosis; cognitive disorders e.g. poor concentration, poor memory, dementia etc
GIT: symptoms of atrophic gastritis or chronic pancreatitis, malabsorption e.g. non-specific abdominal discomfort or pain, bloating, bowel disturbances
Other symptoms of auto-immune disease e.g. vitiligo

37
Q

Briefly outline the production of erythrocytes

A

proerythroblast –> erythroblast –> reticulocyte –> Erythrocyte

38
Q

Briefly outline the production of platelets

A

megakaryoblast –> promegakaryocyte –> megakaryocyte –> platelet

39
Q

Briefly outline the production of basophils, neutrophils and eosinophils

A

myeloblast –> B/N/E. Promyelocyte –> Myelocyte –> Metamyelocyte –> Band –> basophil/neutrophil/eosinophil

40
Q

Briefly outline the production of macrophages

A

Myeloblast –> monoblast –> promonocyte –> monocyte –> macrophage

41
Q

Outline sites at which haemopoiesis occurs and how this changes from the fetus to the adult

A 
Fetus: 0-2 months: yolk sac
2-7 months: liver and spleen
5-9 months: bone and marrow
Infant: bone marrow, most bones
Adult: vertebrae, ribs, sternum, skull, sacrum, pelvis, proximal femur
42
Q

What condition causes normochromic, normocytic anaemia, normal TIBC and ferritin?

A

Chronic disease

43
Q

What condition causes microcytic, hypochromic anaemia, increased TIBC, low ferritin?

A

Iron deficiency

44
Q

What condition causes normochromic, macrocytic anaemia, decreased TIBC, increased ferritin?

A

Chronic liver disease

45
Q

What condition causes normochromic, normocytic anaemia with increased reticulocytes?

A

Haemolysis

46
Q

What condition causes normochromic, normocytic anaemia with reduced reticulocytes?

A

Myelodysplasia

47
Q

What condition causes hypochromic, microcytic anaemia, high red cell count, iron, ferritin and TIBC may be normal?

A

Thalassaemia trait

48
Q

What is the normal ratio of myeloid to erythroid precursors in the marrow?

A

5x more myeloid

49
Q

Presence of red blood cells of unequal size

A

Anisocytosis

50
Q

What is the probable mechanism underlying the non-specific symptoms of anaemia (i.e. fatigue)?

A

Tissue hypoxia

51
Q

Elevated red cell count

A

Polycythaemia

52
Q

Low platelet count

A

Thrombocytopaenia

53
Q

Pernicious anaemia is commonly associated with..?

A

Atrophic gastritis

54
Q

Iron overload

A

Haemochromatosis

55
Q

The presence of an elevated serum bilirubin suggests anaemia due to..?

A

Haemolysis

56
Q

Term used to describe the deposition of iron in body tissues

A

Siderosis

57
Q

Class of drugs that may cause anaemia due to chronic blood loss

A

NSAIDs

58
Q

Neuro-psychiatric condition which may be a clinical manifestation of Vitamin B12 deficiency

A

Dementia

59
Q

Abnormal RBC with spiky projections

A

Acanthocyte

60
Q

… has higher affinity from oxygen than HbA?

A

HbF

61
Q

A type of anaemia characterised by persistence of fetal Hb

A

Thalassemia, sickle cell

62
Q

Macrocytic anaemia associated with peripheral neuropathy may occur with ….. deficiency

A

Folate

63
Q

Severe haemolytic anaemia may be associated with enlargement of the…?

A

Spleen

64
Q

An organ which may be the site of extramedullary erythropoiesis

A

Liver

65
Q

Anaemia due to non-functioning bone marrow?

A

Aplastic anaemia

66
Q

As iron stores are depleted, the concentration of ….. rises while the concentration of ferritin falls

A

Transferrin

67
Q

The presence of of intrinsic factor antibodies is virtually diagnostic of….

A

Pernicious anaemia

68
Q

The presence of ….. on a blood film indicates a functioning bone marrow

A

Reticulocytosis

69
Q

Classic pernicious anaemia is due to failure of …. to produce IF

A

Parietal cells

MEDI2011 (5 decks)

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