Brainscape's Knowledge GenomeTM

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


See full index

3rd Year - Haematology > 3.2. Red Cells - Acquired Anaemias > Flashcards

3.2. Red Cells - Acquired Anaemias Flashcards

1
Q

What is an Acquired Anaemia?

A

A Haemoglobin Below Normal for Age / Sex:

  1. 12-70 Male = 140-180
  2. 12-70 Female = 120-160
  3. > 70 Male = 116-156
  4. > 70 Female = 108-143
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the General Clinical Features of Anaemia?

A
  1. Tiredness
  2. Pallor
  3. Breathlessness
  4. Swelling of Ankles
  5. Dizziness
  6. Chest Pain
    Note - These are due to Reduced O2 Delivery to Tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What Symptoms of Anaemia relate to the Underlying Cause?

A
  1. Evidence of Bleeding - Menorrhagia / Dyspepsia / PR
  2. Malabsorption Symptoms - Diarrhoea / Weight Loss
  3. Jaundice
  4. Splenomegaly / Lymphadenopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 3 Broad Categories of Anaemia Pathophysiologies?

A
  1. Bone Marrow - Cellularity / Stroma / Nutrients
  2. Red Cell - Congenital Anaemias
  3. Destruction - Blood Loss / Haemolysis / Hypersplenism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the Red Cell Indices?

A

Automated Measurements of:
1. Mean Cell Volume (MCV) = Red Cell Size
2. Mean Cell Haemoglobin (MCH) = Haemoglobin Content
Note - This gives a Morphological Description of Anaemia

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

What are the Morphological Descriptions of Anaemia?

Note - These are taken from a Blood Film

A
  1. Hypochromic (Pale) Microcytic (Small)
  2. Normochromic Normocytic
  3. Macrocytic (Large)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What Follow-Up test would you do for a Patient with Hypochromic Microcytic Anaemia?

A

Serum Ferritin - Measure of the Body’s Iron Stores. If:

  1. Low - Iron Deficiency Anaemia
  2. Normal - Thalassaemia / Secondary Anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the Pathway of Iron?

A

Daily Absorption is Balanced by the Daily Loss:
1. Iron is Absorbed from the Diet & Bound to Transferrin
2. This Delivers Iron to Bone Marrow / Liver (Excretion)
3. Iron gets converted into Haemoglobin by Erythroblasts in the Bone Marrow
4. Most of Body’s Iron is in Haemoglobin and Recycled
5. Some Iron stored in Macrophages as Ferritin
Note - Hepcidin is made in response to Low Iron Levels

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

What is the Presentation of Iron Deficiency Anaemia?

A
  1. Dyspepsia / G.I. Bleeding
  2. Other Bleeding (e.g. Menorrhagia)
  3. Diet
  4. Increased Requirement (e.g. Pregnancy)
  5. Atrophic Tongue / Angular Cheilitis
  6. Koilonychia
    Note - This is a Description, not a Diagnosis, a cause must be found
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the Causes of Iron Deficiency Anaemia?

A
  1. G.I. Blood Loss (Worms)
  2. Menorrhagia
  3. Malabsorption - Gastrectomy / Coeliac Disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the Management of Iron Deficiency Anaemia?

A
  1. Correct Cause - Diet / Ulcer Therapy / Surgery

2. Correct Anaemia - Iron (Oral) / Transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What Follow-Up test would you do for a Patient with Normochromic Normocytic Anaemia?

A

Reticulocyte Count - Measure of the “Pre-Erythrocytes”. If:

  1. Increased - Acute Blood Loss / Haemolysis
  2. Normal / Low - Secondary Anaemia / Hypoplasia / Marrow Infiltration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the Causes of Haemolytic Anaemia?

A
  1. Accelerated Erythrocyte Destruction (^Hb)

2. Compensation by Bone Marrow (^Retics)

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

What are the Causes of Haemolytic Anaemia?

A
  1. Congenital - Hereditary Spherocytosis / G6PD Deficiency / Haemoglobinopathy (HbSS)
  2. Acquired:
  3. a) Immune - Mostly Extravascular - Autoimmune
  4. b) Non-Immune - Mostly Intravascular - Mechanical (Artificial Valve) / Severe Infection / Drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does a Direct Antiglobulin Test (DGAT) work?

A
  1. Detects Antibody / Complement on a RBC Membrane
  2. Reagent Contains Anti-Human IgG / Anti-Complement and binds to the Antibody on the RBC Surface
  3. This causes Coagulation in Vitro
  4. Implies Immune Basis for Haemolysis
    Results:
    If Positive = Immune Mediated
    If Negative Non-Immune Mediated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the forms of Immune Mediated Haemolysis?

A
  1. Warm Auto-Antibody
  2. Cold Auto-Antibody
  3. Alloantibody
17
Q

What are the Causes of Warm Auto-Antibody Immune Mediated Haemolysis?

A
  1. Auto-Immune
  2. Drugs
  3. Chronic Lymphocytic Leukaemia
18
Q

What are the Causes of Cold Auto-Antibody Immune Mediated Haemolysis?

A
  1. Cold Haemagglutinin Disease (CHAD)
  2. Infections
  3. Lymphoma
19
Q

What is the Cause of an Alloantibody Immune Mediated Haemolysis?

A

Transfusion Reaction

20
Q

What is the Presentation of Immune (Extravascular) Haemolysis on Film?

A
  1. Spherocytes

2. Agglutination in Cold Autoimmune Haemolytic Anaemia

21
Q

What is the Presentation of Non-Immune (Intravascular) Haemolysis on Film?

A

Red Cell Fragments - Schistocytes

22
Q

What is the Management of Haemolytic Anaemia?

A
  1. Support Marrow Function - Folic Acid
  2. Correct Cause:
  3. a) Immunosupression - if Autoimmune
  4. b) Remove Site if RBC Destruction - Splenectomy
  5. c) Treat Sepsis / Leaky Prosthetic Valve / Malignancy
  6. Consider Transfusion
23
Q

What are the Features of Secondary Anaemia (Anaemia of Chronic Disease)?

A
  1. Defective Iron Utilisation - Increased Hepcidin in Inflammation / Ferritin often Elevated
  2. Identifiable Underlying Disease - Infection / Inflammation / Malignnacy
24
Q

What Follow-Up test would you do for a Patient with Macrocytic Anaemia?

A

Vitamin B12 / Folate Assay. If:

  1. Megaloblastic - B12 / Folate Deficiency
  2. Non-Megaloblastic - Myelodysplasia / Marrow Infiltration / Drugs
25
Q

What are the Symtpoms of Vitamin B12 / Folate Deficiency?

A
  1. Anaemia
  2. Neurological Symptoms - Subacute Combined Degeneration of the Cord in B12 Deficiency
  3. Lemon Yellow Tinge - Bilirubin
26
Q

What are the Causes of:

  1. B12 Deficiency?
  2. Folate Deficiency?
A
  1. a) Pernicious Anaemia - No Intrinsic Factor Produced
  2. b) Gastric / Ileal Disease - Crohn’s Disease
  3. a) Dietary
  4. b) Increased Requirements (Haemolysis)
  5. c) G.I. Pathology - Coeliac Disease
27
Q

What is the Treatment of Megaloblastic Anaemia?

A

Replace Vitamin:
1. B12 Deficiency - B12 IM Injection
2. Folate Deficiency - Oral Folate Replacement
Note - Ensure the B12 is normal if Neuropathic Symptoms

28
Q

What are Rarer causes of Macrocytosis?

A
  1. Alcohol
  2. Drugs - Methotrexate / Antiretrovirals / Hydroxycarbamide
  3. Disordered Liver Function
  4. Hypothyroidism
  5. Myelodysplasia

3rd Year - Haematology (10 decks)

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