3 - Nature and Diagnosis of Anaemia

Question 1

What are the 9 cell types in the stages of erythropoiesis?

Answer 1

1. Haematopoietic stem cell
2. Common myeloid progenitor cell
3. Burst forming unit-erythroid
4. Colony forming unit-erythroid
5. Proerythroblast
6. basophilic erythroblast
7. Polychromatophilic erythroblast
8. Reticulocytes
9. Mature red blood cell

Question 2

What are the causes, blood film appearance, and lab findings of iron deficiency anaemia?

Answer 2

Causes - Chronic blood loss, poor diet, increased demand (pregnancy) or malabsorption (coeliac)

Blood film - microcytic (pencil cells), hypochromic

Lab findings - low serum iron and ferritin. Increased TIBC and RDW

Question 3

What are the causes and lab findings of anaemia of chronic disease?

Answer 3

Causes - Chronic infections and inflammation

Lab findings - low serum iron, low or normal TIBC and MCV, normal or increased ferritin

Question 4

What is the cause, blood film appearance and lab findings of megaloblastic anaemia?

Answer 4

Cause - B12 or folate deficiency impairing thymidine synthase

Blood film - Macrocytic cells, hypersegmented neutrophils

Lab findings - High MCV, low B12 or folate

Question 5

What is the cause and lab findings of anaemia of renal failure?

Answer 5

Cause - Chronic kidney disease, reduced EPO production

Lab findings - normocytic and normochromic cells

Question 6

What is the cause, blood film and lab findings of bone marrow failure anaemia?

Answer 6

Cause - marrow infiltration (leukaemia, lymphoma, solid tumours) or aplastic anaemia

Blood film - nucleated RBCs immature WBC precursors

Lab results - pancytopenia (low RBCs, WBCs and platelets)

Question 7

What is the cause and lab findings of haemolytic anaemias?

Answer 7

Cause - Reduced RBC lifespan due to destruction

Lab results - Increased reticulocyte count, LDH, Bilirubin and reduced haptoglobin

Question 8

What are the causes, blood film appearance and lab findings of non-megaloblastic macrocytic anaemias?

Answer 8

Causes - alcoholism, liver disease, hypothyroidism, pregnancy, chemotherapy

Blood film - Macrocytosis without hypersegmented neutrophils

Lab results - increased MCV

Question 9

What are the two types of haemolytic anaemias?

Answer 9

• Intracorpuscular defects - problems within the red cells (membrane, enzyme or haemoglobin defects)
• Extracorpuscular defects - problems outside the red cells (Autoimmune destruction, mechanical trauma, toxins or infections)

Question 10

What is the main antibody involved in warm reacting antibody AIHA and what are the causes of this condition?

Answer 10

• IgG
• Idiopathic or secondary to lymphoma, autoimmune diseases or drugs)

Question 11

What is the main antibody involved in cold reacting antibody AIHA, what are the three subtypes of this condition and their causes?

Answer 11

• IgM
• Cold hemagglutinin disease (mycoplasma, EBV or lymphoproliferative disease)
• Paroxysmal cold haemoglobinuria (idiopathic, viral infection or syphilis)
• Biphasic Donath-landsteiner reaction