Classification of Anaemia and Iron (haematology) Flashcards
What characterises anaemia?
Low haemoglobin levels below normal.
What are the normal values of Hb for:
1. Children(6mnths-5yrs)
2. Children (5-11yrs)
3. Children (12-14 yrs)
4. Pregnant women
5. Non-pregnant women
6. Men
- 11g/dL
- 11.5 g/dL
- 12 g/dL
- 11g/dL
- 12 g/dL
- 13 g/dL
What are the symptoms of anaemia? (8)
-Confusion, weakness, lethargy, palpitations, headaches, symptoms of heart failure and angina pectoris, difficulty in breathing.
What are the clinical signs of anaemia? (4)
General- hyperdynamic circulation with tachycardia, pallor of mucous membrane or nail beds, systolic flow murmur.
Specific- are associated with particular types of anaemia.
What determine the clinical features of anaemia? (4)
-Age, severity, speed of onset and haemoglobin O2 dissociation curve.
Is anaemia a syndrome or disease?
Syndrome
Two classifications of anaemia with regards to bone marrow response? (4)
-Regenerative anaemia (RPI>3)- bone marrow did try to compensate by producing more RBCs.
-Hypo-regenerative anaemia (RPI<2)- bone marrow did not succeed in compensating for the low RBCs.
What are the causes of microcytic hypochromic anaemia? (2)
- Iron deficiency and chronic inflammation or malignancy.
What is the next step to be taken in normocytic anaemia?
Reticulocyte count
What type of normocytic anaemia has a high reticulocyte count
Haemolysis or blood loss
What are the dietary factors that affect the bioavailability or iron? (2)
Inhibitors such as calcium, oxalic acid, polyphenols and phytates.
Enhancers such as presence of heme iron and ascorbic acid.
What are the factors that regulate hepcidin, and what is hepcidin? (4)
Hepcidin is an iron inhibitor.
Factors affecting the synthesis of hepcidin are:
-Increased transferrin saturation (increases synthesis)
-Decreased transferrin saturation (inhibits synthesis)- IL6, EPO, increased erythropoiesis.
How does hepcidin affect iron? (2)
-It inhibits iron release from macrophages.
-It inhibits iron absorption in small intestines.
What are the five principles of iron deficiency anaemia management? (5)
-Confirm the diagnosis
-Find the cause
-Correct or manage the primary cause.
-Provide iron therapy, either orally or parenterally.
- Check whether the therapy was successful.
What causes iron deficiency? (4)
-Inadequate diet
-Increased demands due to prematurity, pregnancy, adolescence.
- Malabsorption
-Chronic blood loss such as menorrhagia.