Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Haematology > Microcytic Anaemias > Flashcards

Microcytic Anaemias Flashcards

1
Q

Basic cause of microcytic anaemias?

A

Lacking a building block for Hb synthesis, cells continue dividing anyway because other parts fine so cells are small and contain little Hb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does it mean when RBCs are hypochromic?

A

It means they’re lacking in colour because they contain little Hb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Microcytic anaemias are caused by a cytoplasmic or nuclear defect?

A

Cytoplasmic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Deficiency of which substances can cause hypochromic microcytic anaemias? (2)

A

Haem deficiency or globin deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Haem deficiency caused by? (2) Which is most common?

A

lack of iron for erythropoiesis (most common),
or,
problems with porphyrin synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Haem deficiency can be caused by lack of iron for erythropoeisis or by problems with porphyrin synthesis. Give two states in which iron is lacking?

A

iron deficiency (low body iron),
or,
anaemia of chronic disease - normal body iron but lack of available iron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Most anaemia of chronic disease is microcytic/normocytic/macrocytic?

A

normocytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Problems with porphyrin synthesis is rare. List two causes of problems with porphyrin synthesis?

A

lead poisoning,
or,
congenital sideroblastic anaemias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cause of globin deficiency?

A

thalassaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

TAILS - causes of hypochromic microcytic anaemias

A 
Thalassaemia, 
Anaemia of chronic disease, 
Iron deficiency, 
Lead poisoning, 
Sideroblastic anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Top 3 most common causes of microcytic anaemia?

A
  1. iron deficiency,
  2. thalassaemia,
  3. Anaemia of chronic disease (but usually normocytic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where is most of our iron from order of most of iron to least?(6)

A 
In red cell haemoglobin, (2500mg), 
macrophage stores, (500mg), 
parenchymal tissues e.g. liver stores,  (500mg), 
erythroid marrow, (150mg), 
plasma (4mg), 
absorption (1mg/day)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

We can absorb a lot of iron from our dietary intake. T/F?

A

False - can only absorb a small amount of iron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Iron turnover in plasma pool is very fast/slow?

A

Fast - 4mg in pool and move 20mg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Circulating iron is bound to ?

A

transferrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Iron is stored in _____ mainly in the ____.

A

stored in ferritin mainly in the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Functions of iron? (2)

A 
oxygen transport (Hb and myoglobin), 
electron transport (mitochondrial production of ATP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you test functional iron?

A

Haemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do you test transported iron? (3)

A

Serum iron,
Transferrin,
transferrin saturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do you test storage iron?

A

Serum ferritin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How many binding sites does transferrin, the protein, have for iron?

A

2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where does transferring transport iron from and to?

A

from donor tissues e.g. macrophages, intestinal cells and hepatocytes to tissue expressing transferring receptors (especially erythroid marrow)

23
Q

What does % saturation of transferrin with iron measure?

A

Iron supply

24
Q

In what 2 instances is %saturation of transferrin with iron reduced?

A

iron deficiency,

anaemia of chronic disease

25
Q

In what instance is % saturation of transferrin with iron increased?

A

Genetic haemachromatosis

26
Q

Ferritin is a large intracellular protein and can store up to ____ ferric ions?

A

4000

27
Q

There is a tiny amount of ferritin present in serum and it reflects intracellular ferritin synthesis in response to iron status of the host. Low ferritin means

A

Iron deficiency

28
Q

How is iron deficiency confirmed?

A

Combo of anaemia and reduced storage iron i.e. decreased functional iron and low serum ferritin

29
Q

What are 3 basic causes of iron deficiency?

A

not getting sufficient dietary iron,
losing iron,
malabsorption

30
Q

What are two types of iron deficiency due to insufficient dietary intake?

A 
absolute deficiency (rare in UK, usually veggie diets with other issues), 
relative deficiency more common especially in children and women of child bearing age
31
Q

What are 3 examples of causes of iron deficiency due to blood loss?

A

Usually gastrointestinal e.g. tumours, ulcers, NSAIDS
menorrhagia,
haematuria

32
Q

What are 2 causes of malabsorption of iron? (relatively uncommon)

A

coeliac disease,

achlorhydria

33
Q

How can menstrual blood loss lead to iron deficiency?

A

Average blood loss is 30-40ml/month which is equivalent to 15-20mg iron/month. average daily intake 1mg/day so if heavy menstrual blood loss e.g. >60ml that means >30mg iron loss/month

34
Q

List 4 sequential consequences of negative iron balance

A
  1. ferritin falls because stores exhausted,
  2. MCV falls because iron deficient erythropoiesis,
  3. Microcytic anaemia develops (may be relative),
  4. epithelial changes
35
Q

List 3 epithelial changes of low iron

A

skin,
koilonychia,
angular chelitis

36
Q

Iron deficiency is a diagnosis. T/F?

A

FALSE - symptom not diagnosis!! needs investigation

37
Q

List 3 non-drug managements to improve iron intake

A

review diet - haem and non-haem iron,
improve gastric acidity,
review other medications e.g. anticoagulants, PPIs

38
Q

If good supply of iron, how much can healthy bone marrow increase Hb concentration per week?

A

7-10g/L

39
Q

Oral iron is best given on an empty/full stomach

A

empty

40
Q

What is standard daily oral iron dose?

What dose may be sufficient?

A

100-200mg,

65mg may be sufficient

41
Q

What are the 3 types of oral iron available in tablet form?

A

ferrous sulphate,
ferrous fumarte,
ferrous gluconate

42
Q

What is the name of the liquid prep with lower iron concentration used in paeds?

A

Soium feredetate sytron)

43
Q

Side effects of oral iron? (5)

A 
constipation, 
nausea, 
vomiting, 
abdo pains, 
dark stools
44
Q

When should you consider IV iron?

A

Only when oral unsuccessful due to poor tolerance,
poor compliance,
malabsorption (rare)

45
Q

How are IV iron doses calculated?

A

based on degree of anaemia and patient weight

46
Q

With both oral and IV iron, how long after starting treatment should you assess response?

A

4-6 weeks

47
Q

If poor response to iron therapy, what are potential causes? which is most common and which is least common?

A

poor compliance (most common),
iron intake not matching loss,
ongoing blood loss,
malabsorption (rare)

48
Q

In cases of poor compliance with iron therapy due to side effects, what is clinical management?

A

reduce frequency,
or
switch to lower iron containing prep,
or consider IV route

49
Q

What should rise on FBC if good response to iron therapy? (3)

A

Hb,
MCV,
Reticulocyte count

50
Q

How long do you typically need to continue iron therapy for stores to be replenished?

A

2-3 months

51
Q

IV iron has a significantly better and faster response than well tolerated oral iron. T/F?

A

False - not necessarily better/faster

52
Q

Which iron is found in plants and which in meat and which are we designed to absorb more readily?

A

Ferric in plants, ferrous in meat, designed to absorb ferrous more easily

53
Q

Why are pernicious anaemia patients jaundiced?

A

ineffective erythropoiesis sp destruction in bone marrow, Hb leftover and forms bilirubin

Haematology (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions