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A. Block C Paediatrics > Anaemia > Flashcards

Anaemia Flashcards

1
Q

Anaemia is when the body has insufficient RBCs to circulate oxygen around the body. Which of the following is NOT a common presentation of anaemia?

1 - dyspnea upon exertion and rest
2 - fatigue
3 - pallor
4 - hypodynamic state (slow HR and weak pulse)

A

4 - hypodynamic state (slow HR and weak pulse)
- patients are in a hyperdynamic state and have palpitations and a bounding pulse to try to compensate for low RBCs and oxygen

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2
Q

Myeloid progenitor cells will be stimulated to become reticulocytes, which is an immature RBC. What is the main hormone is responsible for maturing myeloid progenitor cells into reticulocytes?

1 - calcitriol
2 - erythropoietin
3 - androgen
4 - T3 and T4

A

2 - erythropoietin

  • reticulocytes enter the blood stream after 3 days and mature into RBCs
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3
Q

Anaemia is the a condition in which the body does not have enough healthy erythrocytes, which are immature RBCs. To stimulate proerythroblast in the bone marrow, which organ secretes most of the erythropoietin in the body?

1 - heart
2 - bone
3 - liver
4 - kidney

A

4 - kidney

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4
Q

RBCs contain a protein called haemoglobin. Each haemoglobin contains 4 heme molecules. What is contained at the centre of the heme molecules?

1 - Ca2+
2 - Mg2+
3 - iron
4 - vitamin B1

A

3 - iron
- important for binding to O2
- each haemoglobin can bind 4 molecules of O2

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5
Q

When trying to determine if a patient has anaemia we need to measure mean corpuscular volume (MCV). What is this a measure of?

1 - average concentration of Hb
2 - average size of RBCs
3 - average size of WBCs
4 - concentration of platelets

A

2 - average size of RBCs

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6
Q

What is the definition of anaemia in men?

1 - <220 g/L Haemoglobin (Hb)
2 - <180 g/L Haemoglobin (Hb)
3 - <140 g/L Haemoglobin (Hb)
4 - <100 g/L Haemoglobin (Hb)

A

3 - <140 g/L Haemoglobin (Hb)

This is 2 x SD below the normal level adjusted for age

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7
Q

What is the definition of anaemia in women?

1 - <200 g/L Haemoglobin (Hb)
2 - <180 g/L Haemoglobin (Hb)
3 - <120 g/L Haemoglobin (Hb)
4 - <100 g/L Haemoglobin (Hb)

A

3 - <120 g/L Haemoglobin (Hb)

This is 2 x SD below the normal level adjusted for age

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8
Q

The average life of an RBC is 120 days. Which organ is responsible for removing RBCs ponce they are old and need removing?

1 - spleen
2 - kidney
3 - liver
4 - lungs

A

1 - spleen

  • also able to remove abnormal RBCs
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9
Q

Generally, if we suspect a patient has anaemia, we may perform all of the following, EXCEPT which one?

1 - FBC
2 - Iron studies
3 - Ferritin
4 - Blood Film
5 - Imaging
6 - B12 and Folate

A

5 - Imaging

May be used once a diagnosis is reached, depending on the suspicioun, but not routinely

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10
Q

When trying to diagnose anaemia we use the Mean corpuscular volume (MCV). What is the diagnosis of microcytic anaemia (small RBCs) based on MCV?

1 - <80fl
2 - <100fl
3 - <120fl
4 - <150fl

A

1 - <80fl

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11
Q

When trying to diagnose anaemia we use the Mean corpuscular volume (MCV). What is the diagnosis of normocytic anaemia (normal size RBCs) based on MCV?

1 - 60-80fl
2 - 80-100fl
3 - 100-120fl
4 - 120-150fl

A

2 - 80-100fl

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12
Q

When trying to diagnose anaemia we use the Mean corpuscular volume (MCV). What is the diagnosis of macrocytic anaemia (normal size RBCs) based on MCV?

1 - >80fl
2 - >90fl
3 - >100fl
4 - >120fl

A

3 - >100fl

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13
Q

Which of the following is NOT a cause of normoocytic anaemia (normal size RBCs) with a value 80-100fl?

1 - thalassaemia
2 - renal failure
3 - blood loss
4 - bone marrow disorder

A

1 - thalassaemia
- this causes microcytic anaemia

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14
Q

Which of the following is NOT a cause of microcytic anaemia (small RBCs) with a value <80fl?

1 - thalassaemia
2 - iron deficiency anaemia
3 - haemolytic anaemia
4 - anaemia of chronic disease

A

3 - haemolytic anaemia
- typically causes normocytic anaemia

Thalassaemia = low Hb
- type A = alpha globin deficiency
- type B = beta globin deficiency

  • alpha is more common
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15
Q

Which of the following is NOT a cause of macrocytic anaemia (small RBCs) with a value >100fl?

1 - B12/Folate deficiency
2 - iron deficiency anaemia
3 - thyroid dysfunction
4 - myelodysplasia

A

2 - iron deficiency anaemia

myelodysplasia = rare blood cancer

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16
Q

Normoocytic anaemia (normal size RBCs) is when there is a value 80-100fl. What is used to identify the cause the normocytic anaemia?

1 - Hb
2 - WBCs
3 - platelet count
4 - reticulocyte count

A

4 - reticulocyte count

  • high = haemolytic anaemia and blood loss
  • low = bone marrow disorder
17
Q

Macrocytic anaemia (normal size RBCs) is when the MCV is >100fl. What is used to identify the cause the macrocytic anaemia?

1 - blood film
2 - WBCs
3 - platelet count
4 - reticulocyte count

A

1 - blood film
Distinguish between:

  • megaloblastic anaemia = large immature RBCs
  • non-megaloblastic anaemia = large mature RBCs
18
Q

Macrocytic anaemia (normal size RBCs) is when the MCV is >100fl. Usinga. blood film we can distinguish between megaloblastic anaemia (large immature RBCs) and non-megaloblastic anaemia (large mature RBCs). Which of the following is NOT a cause of megaloblastic anaemia?

1 - vitamin B12 deficiency
2 - chronic inflammatory disease
3 - folic acid deficiency
4 - drug induced toxicity (methotrexate)

A

2 - chronic inflammatory disease

19
Q

Macrocytic anaemia (normal size RBCs) is when the MCV is >100fl. Using a blood film we can distinguish between megaloblastic anaemia (large immature RBCs) and non-megaloblastic anaemia (large mature RBCs). Which of the following is NOT a cause of non-megaloblastic anaemia?

1 - alcohol abuse
2 - pregnancy
3 - hypothyroidism
4 - drug induced toxicity (methotrexate)

A

4 - drug induced toxicity (methotrexate)

20
Q

There are a number of mechanisms that can lead to anaemia. One of these is a reduction in erythropoiesis, RNC production. Which of the following is NOT a cause of reduced erythropoiesis?

1 - CKD
2 - bone marrow disorder
3 - hypothyroidism
4 - vit B12 and iron deficiency
5 - blood loss
5 - chronic inflammatory disease

A

5 - blood loss

21
Q

There are a number of mechanisms that can lead to anaemia. One of these is blood loss. Which of the following is NOT a cause blood loss?

1 - menorrhagia
2 - trauma / accidents
3 - hypothyroidism
4 - GI bleed

A

3 - hypothyroidism

22
Q

There are a number of mechanisms that can lead to anaemia. One of these is increased destruction (haemolysis) of RBCs. This can be divided intravascular and extravascular. Which of the following is NOT a cause intravascular haemolysis?

1 - Disseminated Intravascular Coagulation
2 - Type 1 diabetes
3 - Thrombotic Thrombocytopenic Purpura
4 - Hemolytic uremic syndrome
5 - Mechanical heart valves

A

2 - Type 1 diabetes

23
Q

There are a number of mechanisms that can lead to anaemia. One of these is increased destruction (haemolysis) of RBCs. This can be divided intravascular and extravascular. Which of the following is NOT a cause extravascular haemolysis?

1 - liver cirrhosis
2 - hypersplenism
3 - inherited haemolytic anaemia (sickle cell disease)
4 - acquired haemolytic anaemia (malaria)

A

1 - liver cirrhosis

24
Q

To determine if a patient has a haemolysis cause of anaemia we can measure the blood. Which of the following is NOT one of these measures?

1 - lactate dehydrogenase
2 - iron
3 - unconjugated bilirubin
4 - haemoglobin
5 - globin
6 - creatine kinase

A

6 - creatine kinase

  • all the others are contained within RBCs, so if there is haemolysis then this may be raised
25
Q

Which of the following is NOT a typical laboratory investigation performed if we suspect haeolysis?

1 - lactate dehydrogenase
2 - creatine kinase
3 - bilirubin
4 - haptoglobin

A

4 - haptoglobin
- this binds with free haemoglobin if haemolysis occurs, so this would be low

26
Q

Which of the following is NOT a typical presentation of anaemia?

1 - pallor / conjunctive pallor
2 - fatigue
3 - scleral icterus (jaundice)
4 - ascites
5 - bony tenderness
6 - lymphadenopathy
7 - dyspnea upon exertion /rest
8 - splenomegaly

A

4 - ascites

27
Q

In paediatrics, what is the most common cause of anaemia?

1 - leukaemia
2 - lymphoma
3 - iron deficiency
4 - excess milk
5 - renal failure

A

3 - iron deficiency

Can be treated with iron supplements for 3 months

A. Block C Paediatrics (50 decks)

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