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JG Year 2 > 231 Anaemia > Flashcards

231 Anaemia Flashcards

1
Q

What are the progenitor cells of RBCs?

A

BFU-GEMM (burst forming units) Granulocute Erythrocyte Monocyte Megakaryocyte

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2
Q

Which RBC progenitor contains: - basophilic cytoplasm - lots of organelles - no Hb - sparse chromatin

A

Pronormoblasts

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3
Q

Which RBC precursor synthesises 20-30% of total Hb?

A

reticulocytes

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4
Q

Where is the majority of EPO synthesised?

A

Peritubular cells of the kidney

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5
Q

Where is 10% of EPO synthesised?

A

Kupffer cells and hepatocytes in the liver

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6
Q

What is the major stimulus for EPO release?

A

Hypoxia

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7
Q

Name 2 conditions where recombinant EPO is used as treatment (4 listed)

A
  1. Anaemia due to renal failure 2. Autologous blood transfusion 3. Post chemo/bone marrow transplantation 4. Myeloblastic syndromes
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8
Q

Which vitamin aids ferric iron absorption?

A

Vit C

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9
Q

Where is Fe3+ converted into Fe2+?

A

Stomach

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10
Q

Where in the GIT is Fe2+ absorbed?

A

Duodenum and jej

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11
Q

Fe2+ + apoferritin = ?

A

Ferritin

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12
Q

What is ferritin?

A

Intracellular protein which stores iron

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13
Q

What is transferrin?

A

Protein in the blood which binds to and transports iron around the body

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14
Q

What is hepcidin?

A

Peptide hormone synthesised in the liver and regulates iron metabolism and absorption

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15
Q

What are Vit B12 and folate important for?

A

DNA synthesis and mitosis

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16
Q

What type of anaemia is seen in a patient with folate and VitB12 deficiency?

A

Megaloblastic

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17
Q

What is the mechanism of pernicious anaemia?

A

IgG autoantibodies against parietal cells in the stomach which also make IF. IF important for absorption of VitB12 in distal ileum –>B12 deficiency and anaemia

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18
Q

What is the most common cause of iron deficiency anaemia in women of child bearing age?

A

Menstruation

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19
Q

What is the most common cause of iron deficiency anaemia in post menopausal women?

A

GIT bleeds

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20
Q

What are the general causes of iron deficiency anaemia?

A
  1. reduced iron intake
  2. reduced iron absorption
  3. increased requirement for iron
  4. chronic blood loss
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21
Q

What is the morphology RBCs in iron deficiency anaemia?

A

Microcytic hypochromic

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22
Q

What are the FBC features of iron deficiency anaemia?

A
  • ↓ iron
  • ↓ ferritin
  • ↑ transferritin
  • ↑ TIBC
  • ↓ plasma transferrin saturation
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23
Q

Name 2 specific features of iron deficiency anaemia

(5 listed)

A
  1. Glossitis
  2. Koilonychia
  3. Angular stomatitis
  4. Alopecia
  5. Pica
24
Q

What is the mechanism behind anaemia of chronic disease?

A

Anaemia due to activation of cellular immunity and production of pro-inflammatory cytokines which decreases erythrocpoiesis

25
Q

What is the morphology of RBCs in anaemia of chronic disease?

A

Normocytic/microcytic and normochromic

26
Q

What is the treatment of iron deficiency anaemia?

A

Ferrous sulphate tablets

27
Q

Name 3 features of haemolytic anaemia

(6 listed)

A
  1. pallor
  2. jaundice (increased unconjugated BR)
  3. Dark urine (increased urobilinogen)
  4. Pigment gallstones
  5. Splenomegaly
  6. Reticulocytosis (increased MCV)
28
Q

What is the reason for bone deformities in haemolytic anaemia?

A

Eythroid hyperplasia

29
Q

Name 3 causes of haemoltic anaema

(6 listed)

A
  1. hereditdary spherocytosis
  2. pyruvate kinase deficiency
  3. G6PD
  4. drug induced
  5. mechanical
  6. Microangiopathic haemolytic anaemia
30
Q

What is hereditary spherocytosis?

A

Autosomal dominant condition where there’s a defect in spectrin (cytoskeletal protein) which causes loss of the membrane spherocytosis and haemolysis

31
Q

What is the mechanism of haemolytic anaemia in G6PD deficiency?

A

X linked condition which affects glucose 6 phosphate dehydrogenase in the hexose monophosphate shunt normally responsible for excreting waste in the RBC

32
Q

What is the mechanism of haemolytic anaemia in pyruvate kinase deficiency?

A

AR disorder which affects the glycolytic pathway meaning decrease of ATP and RBCs become rigid and get destroyed

33
Q

Which drugs can induce haemolytic anaemia?

A

Penicillin, cephalosporins, flu-darabine

34
Q

Which metel can cause haemolytic anaemia?

A

Lead poisoning

35
Q

What is microangiopathic haemolytic anaemia?

A

Fibrin is deposited in the small vessels causing haemolysis

36
Q

What is the morphology of RBCs in þ-thalassaemia?

A

Microcytic hypochromic with reticulocytosis

37
Q

What does HbH disease cause?

A

Chronic haemolysis

38
Q

What is the cause of hydrops fetalis?

A

No alpha globulin genes and foetus dies un utero

39
Q

Why is there hyposplenism in sickle cell disease?

A

Infarctions of splenic vessels

40
Q

Name 2 causes of microcytic, hypochromic anaemia

(3 listed)

A
  • Iron deficiency
  • Thalassaemia
  • Sideroblastic
41
Q

Name 2 causes of normocytic, normochromic anaemia

(3 listed)

A
  • Haemolysis
  • Chronic disease
  • Marrow infiltration
  • Iron deficiency WITH b12 deficiency
42
Q

Which measurement of the FBC is raised in iron deficiency and B12 deficiency?

A

RDW - red cell distribution width

43
Q

Name 2 causes of target cells

(3 listed)

A
  • Obstructive jaundice
  • Thalassaemia
  • Sickle cell
44
Q

What type of cells can be seen due to oxidant damage in e.g. G6PD deficiency?

A

Basket/blister cells

45
Q

Which membrane protein is defective and can cause elliptocytosis in haemolytic anaemias?

A

Spectrin

46
Q

Name 2 conditions where you would see fragments on a blood film?

(5 listed)

A
  • DIC
  • TTP
  • Burns
  • Cardiac valves
  • Microangiopathy
47
Q

In which condition would you see pencil cells on a blood film?

A

Iron deficiency

48
Q

What are prickle cells?

A

RBCs seen on blood film post splenectomy characteristic of pyruvate kinase deficiency

49
Q

Would there be a right or left shift in the oxygen dissociation curve during alkalosis?

A

Left shift

50
Q

What can cause a right shift in the oxygen dissociation curve?

A
  • increased conc of 2,3 DPG
  • Acidosis
  • Increased CO2
51
Q

On which chromosome is the beta globulin gene on?

A

11

52
Q

On which chromosome are the alpha globulin genes on?

A

Chromosome 16

53
Q

What is hydroxocobalamin?

A

B12 injections

54
Q

What are desferoxiamine and deferasirox?

A

Iron chelators

55
Q

What are venofer and cosmofer?

A

Perenteral iron

JG Year 2 (28 decks)

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