microcytic anaemia

Question 1

what does transferrin show

Answer 1

total iron binding capacity

Question 2

what causes raised total iron binding capacity

Answer 2

raised in iron deficiency // raised in pregnancy

Question 3

how is transferin saturation calculated

Answer 3

iron / TIBC

Question 4

what is ferritin

Answer 4

storage iron

Question 5

what raises ferritin

Answer 5

inflamm disorders

Question 6

what lowers ferritin

Answer 6

iron deficiency

Question 7

bloods in anaemia chronic dosease

Answer 7

normo/ hypochromic, normocytic anaemia // reduced transferrin saturation and TIBS // normal or raised ferritin

Question 8

causes microcytic anaemia

Answer 8

TAILS: thalassaemi, anaemia chronic disease, iron def, lead, sideroblastic

Question 9

what can sometimes cause a normal Hb but low MCV

Answer 9

thalassaemia // polycythaemia rubra secondary to bleeding

Question 10

what can cause iron deficiency anaemia

Answer 10

bleeding eg menorrhagia, GI bleed // diet eg veggie // malabsorption eg coeliac // increased requirements eg growing kids, pregnancy

Question 11

symptoms iron def anaemia

Answer 11

fatigue, SOB, paliptations, koilonychia (spoon nail), hair loss, atrophic glossitis, angular stomatits

Question 12

bloods iron def anaemia (FBC, ferritin, TIBC + transferrin)

Answer 12

FBC = hypochromic microcytic anaemia // ferritin low // TIBC + transferrin = high

Question 13

films iron def anaemia

Answer 13

target cells, pencil poikilocytes

Question 14

when is endoscopy indicated iron def anaemia

Answer 14

males and post menopausal females // women Hb <10 and mens <12 –> 2 week cancer referral

Question 15

mx iron def

Answer 15

ferrous sulfate, diet eg dark veg, meat

Question 16

how long should iron def mx be given and common SE

Answer 16

3 months after def fixed // GI upset

Question 17

what can cause anaemia of chronic disease

Answer 17

recurrent inflamm, infection, malignancy

Question 18

how does anaemic of chronic disease cause anaemia

Answer 18

chronic inflamm –> cytokines –> activate hepicidin (which inhibits iron release) + inhibits EPO

Question 19

bloods anaemia chronic disease

Answer 19

low Hb, normo or hypocytic // raised ferritin (bc not a problem with iron stores, problem with it being released)

Question 20

symptoms lead poisoning

Answer 20

abdo pain // peripheral neuropathy // blue lines on mouth // psych // fatigue // constipation

Question 21

what blood levels are significant in lead

Answer 21

10 mcg

Question 22

FBC and bloods lead

Answer 22

microcytic anaemia // raised delta aminolaevulinc acid // urin copropophyron

Question 23

what condition does lead poisoning present similarly too

Answer 23

acute intermittent porphoryia

Question 24

blood film lead

Answer 24

basophilic stippling

Question 25

mx lead poisioning

Answer 25

dimercaptosuccinic acid (DMSA) // D-penicillamine // EDTA // dimercaprol

Question 26

how does sideroblastic anaemia cause naemia

Answer 26

haem not fully formed –> iron in mitochdria which form rung around nucleus

Question 27

causes sideroblastic anaemia

Answer 27

delta synthase 2 def // myelodysplasia // alcohol // lead // anti-TB meds

Question 28

FBC, ferritin, iron, transferrin sideroblastic anaemia

Answer 28

hypochromic microcytic anaemia // high ferritin // high iron // high transferrin saturation

Question 29

blood film and bone marrow sideroblastic anaemia

Answer 29

basophilic stipping + looks like a ring // bone marrow - blue staining

Question 30

mx sideroblastic anaemia

Answer 30

conservative +/- pyridoxine