Normocytic anaemia

Question 1

Define:

Answer 1

Anaemia with normal MCV (80-100 fl)

Question 2

Aetiology:

Answer 2

Acute blood loss - peptic ulcer, oesophageal varices, trauma

Failure of RBC production

Early stages of ID or ACD

Increased plasma volume not compensated for - pregnancy and fluid overload

Haemolysis (may be macro also)

Hypersplenism (portal cirrhosis)

Question 3

What are causes of failure of RBC production:

Answer 3

 Bone marrow failure or suppression e.g. aplastic anaemia, chemotherapy
 Bone marrow infiltration e.g. malignancy
 Renal failure – abnormal erythropoietic drive
 Early stages of iron deficiency or anaemia of chronic disease
 Hypothyroidism (can be macrocytic)
 Vitamin B2 deficiency
 Vitamin B6 deficiency

Question 4

Epidemiology:

Answer 4

Common

Question 5

Signs and symptoms:

Answer 5

• Fatigue
• Dyspnoea
• Faintness
• Palpitations
• Headache
• Tinnitus
• Anorexia
• Angina if pre-existing CAD
• Conjunctival pallor

Question 6

Investigations:

Answer 6

FBC - MCV normal but Hb low

If low platelets and WCC = BONE MARROW FAILURE SHOULD BE SUSPECTED

Hx of haemorrhage