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Year 3 - MedEd Lectures > Anaemia > Flashcards

Anaemia Flashcards

1
Q

What are the most common signs of Anaemia?

A

Skin & Mucosal Pallor

Conjunctival Pallor

Fatigue

Tachypnoea

Tachycardia

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2
Q

How does Iron Deficiency Anaemia look on Blood Film?

A

Poikilocytosis (Unequal shape)

Pencil Cells

Hypochromic and Microcytic

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3
Q

What causes Iron Deficiency Anaemia?

A

Reduced Uptake - Malnutrition, Coeliac, IBD, Achlorhydria

Increased Loss - GI Cancer, Peptic Ulcer, IBD, Menstruation

Increased Requirement - Pregnancy, Breastfeeding

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4
Q

What is the triad of presenting symptoms associated with Colon Cancer?

A

Weight Loss

PR Bleeding

Unexplained IDA

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5
Q

How do you differentiate between IDA and ACD on blood tests?

A

IDA - Low Ferritin, High TIBC

ACD - High Ferritin, Low TIBC

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6
Q

What is Thalassaemia?

A

Globin Chain mutations, causing quantitative defects in the Alpha or Beta chains of Haemoglobin

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7
Q

What are the key features of Thalassaemia?

A

‘Greek Cyprus Origin’

Severity of Anaemia depends on the Thalassaemia

, Beta Major and HbH most severe.

Microcytic

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8
Q

What is Sickle Cell?

A

Autosomal Recessive disorder causing the formation of HbS, whcih has a weaker membrane when deoxygenated and is prone to intravascular haemolysis.

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9
Q

What may you see on the blood film of someone with Sickle Cell Disease?

A

Howell-Joly Bodies

Sickled Cells

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10
Q

How can Sickle-Cell Crises present?

A

Acute Painful Crisis

Stroke

Sequestration Crisis

Chronic Cholecystitis

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11
Q

What are the key presenting features of Sickle Cell?

A

Dactilytis

Actue Chest Syndrome

Haemolytic Anaemia

Aplastic Crisis

Priapism

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12
Q

How is Sickle Cell diagnosed?

A

Hb Electrophoresis

Blood Film

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13
Q

How do you manage a patient with Sickle Cell?

A

Trigger Avoidance

Vaccinations, Hydroxyurea, Prophylactic Antibiotics

Bone Marrow Transplant

Fluids, Analgesia, Oxygen (In a crisis)

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14
Q

What can cause a Microcytic Anaemia?

A

Iron-Deficiency

Chronic Disease

Thalassaemia

Sickle Cell

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15
Q

What might you see on the Blood Film of a patient with Folate or B12 deficiency?

A

Hypersegmented Neutrophils

Macrocytic Cells

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16
Q

What can cause a Vitamin B12 Deficiency?

A

Alcohol

IBD/Coeliac

Bariatric Surgery

Malnutrition

Pernicious Anaemia

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17
Q

What can cause a Folate Deficiency?

A

Alcohol

IBD/Coeliac

Anti-Folate Drugs

Pregnancy

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18
Q

What are the main symptoms of B12 Deficiency?

A

Megaloblastic Anaemia

+ Neuro Signs

Glove + Stocking paraesthesia

Hyporeflexia

Romberg’s +ve

Subacute combined degeneration of the cord

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19
Q

What is Pernicious Anaemia?

A

Autoimmune mediated B12 Deficiency.

Anti-Parietal Cells

Anti-Intrinsic Factor

20
Q

How does Folate Deficiency present?

A

Classic Megaloblastic Anaemia

21
Q

What are the non-megaloblastic causes of a Macrocytic Anaemia?

A

Alcoholics May Have Liver Failure

Alcohol

Myelodysplasia

Hypothyroidism

Liver Disease

22
Q

How does Haemolytic Anaemia present?

A

Scleral Icterus

Pallor

Conjunctival Pallor

‘Anaemia & Jaundice’

23
Q

What are the main types of Hereditary Haemolytic Anaemia?

A

Hereditary Spherocytosis

G-6-PD Deficiency

Sickle Cell

Thalassaemia

24
Q

What is the DAT/Coombs Test?

A

Direct Antiglobulin Test

Detects the presence of antibodies bound to RBCs (basically determines whether it’s autoimmune or not)

25
Q

What should be avoided in G6PD Deficiency?

A

Oxidative stressors, such as antimalarials, broad beans and ‘napthalene moth ball’.

26
Q

What might you see on the blood film of someone with G6PD Deficiency?

A

Heinz Bodies

Bite Cells

27
Q

What is Hereditary Spherocytosis?

A

Autosomal Dominant condition leading to the formation of spherocytes due to the defective attachment of the cytoskeleton to membrane proteins.

28
Q

How do you investigate a suspected case of Hereditary Spherocytosis?

A

Osmotic Fragility Test leads to cell lysis

Coombs test Negative

29
Q

What are the complications of Hereditary Spherocytosis?

A

Aplastic Crisis, often caused by Parvovirus B19 infection

30
Q

What is Microangiopathic Haemolytic Anaemia?

A

Microthrombi formation due to platelet cross-linking leads to the shearing of RBCs and the formation of schistocytes.

31
Q

How does Haemolytic Uraemic Syndrome typically present?

A

Young Children

GI (E.Coli)- Abdominal Pain, Blood Diarrhoea

Renal - Oliguria, Creatinine rise

Haemolysis - Jaundice

32
Q

What is Disseminated Itravascular Coagulation?

A

Severe concurrent Clotting and Bleeding.

Too much clotting = thrombocytopaenia = severe bleeding

33
Q

What can cause Disseminated Intravascular Coagulation?

A

Pancreatitis

Sepsis

Obstetric Complications

Cancers

Trauma

ABO Reaction

34
Q

How does DIC present?

A

Bleeding - eg. Petechiae, Haematuria, Ecchymoses

Clotting - eg. PT/APTT prolongation

Haemolysis - eg. Jaundice

35
Q

What is Thrombotic Thromocytopenic Prupura?

A

Condition caused by a defunct ADAMTS-13 Enzyme

Causes: Thrombocytopaenia, AKI, MAHA, Fever, Swinging CNS Signs

36
Q

What is Anti-Phospholipid Syndrome?

A

Autoimmune mediated thombosis that commonly manifests during pregnancy, sadly causing miscarriage

37
Q

What are the main clinical features of Anti-Phospholipid Syndrome?

A

Recurrent Miscarriages

VTE

Stroke/MIs

HTN

‘Livedo reticularis’

38
Q

How would you investigate suspected Anti-Phospholipid Syndrome?

A

Anti-Cardolipin + Lupus Anti-Coagulant test

both +ve

39
Q

What is Polycythaemia Rubra Vera?

A

Myeloproliferative disorder characterised by the increased production of RBCs by bone marrow.

40
Q

How does Polycythaemia Rubra Vera typically present?

A

Older

Asymptomatic usually

Itchiness after a hot bath

Hyperviscosity Syndrome - eg. retinopathy, headache

41
Q

How would you investigate suspected Polycythaemia Rubra Vera?

A

Polycythaemia, Raised haematrocrit

+/- Thrombocytosis

JAK2 V617F +ve

42
Q

What is Myelofibrosis?

A

BM Fibrosis in response to bone marrow malignancy.

Moderate association with JAK2 mutation

43
Q

What would you see when investigating a case of Myelofibrosis?

A

‘Dry Tap’ on BM Aspiration

‘Tear Drop Cells’ on Blood Film

44
Q

What is Aplastic Anaemia?

A

Bone Marrow Failure causing Pancytopenia.

Autoimune mediated

45
Q

How does Aplastic Anaemia present?

A

Hypocellular BM Aspirate

Anaemia + Raised EPO

Blleding, Petechiae

Sepsis, Recurrent Infections

Year 3 - MedEd Lectures (29 decks)

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