Microcytic Anaemia Flashcards

1
Q

Define Microcytic Anaemia?

A

Anaemia associated with a low MCV (< 80 fl)

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2
Q

What are the causes of Microcytic Anaemia?

A

Iron Deficiency - Most Common
Anaemia of Chronic Disease
Thalassemia
Sideroblastic Anaemia

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3
Q

What are the causes of Iron Deficiency?

A
Blood Loss (e.g. GI)
Reduced absorption (e.g. small bowel disease)
Increased demands (e.g. growth, pregnancy)
Reduced intake (e.g. vegans)
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4
Q

What is Anaemia of Chronic Disease?

A

Microcytic Anaemia in a patient with chronic disease

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5
Q

What is Sideroblastic Anaemia?

A

Abnormality of haem synthesis

It can be inherited or it can be secondary (e.g. to alcohol, drugs)

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6
Q

What is the epidemiology of Microcytic Anaemia?

A

Iron deficiency anaemia is the MOST COMMON form of anaemia worldwide

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7
Q

What are the symptoms of Microcytic Anaemia?

A

Non-Specific

Lead Poisoning Symptoms

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8
Q

What is the signficance of Lead Poisoning and Microcytic Anaemia?

A

Lead poisoning can cause Microcytic Anaemia

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9
Q

What are the Non-Specifc presenting symptoms of Microcytic Anaemia?

A
Tiredness 
Lethargy 
Malaise 
Dyspnoea 
Pallor 
Exacerbation of ischaemic conditions (e.g. angina, intermittent claudication)
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10
Q

What are the symptoms of Lead Poisoning?

A
Anorexia
Nausea/vomiting 
Abdominal pain
Constipation
Peripheral nerve lesions
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11
Q

What are the signs of Microcytic Anaemia on physical examination?

A
Signs of Anaemia 
Glossitis 
Angular Stomatitis 
Signs of Thalassaemia 
Lead Poisoning Signs
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12
Q

What are the signs of anaemia for Microcytic Anaemia on physical examination?

A

Pallor
Brittle nails and hair
Kolionychia (if severe)

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13
Q

What are the Lead Poisoning Signs of Microcytic Anaemia?

A
Blue gumline 
Peripheral nerve lesions (causing wrist or foot drop)
Encephalopathy
Convulsions 
Reduced consiousness
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14
Q

What investigatiosn would you do for Microcytic Anaemia?

A
Bloods 
Blood Film
Hb Electrophoresis 
Sideroblastic Anaemia 
Special investigations
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15
Q

What bloods do we do for Microcytic Anaemia?

A
FBC 
Serum Iron
Total Iron Binding Capacity 
Serum Ferritin
Serum lead
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16
Q

What do we look for specifcally on the FBC for Microcytic Anaemia?

A

Low Hb
Low MCV
Reticulocytes

17
Q

What do we see with the serum iron for Microcytic Anaemia?

A

Low in iron deficiency

18
Q

What do we see with Total Iron Binding Capacity for Microcytic Anaemia?

A

High in iron deficiency

19
Q

What do we see on Serum Ferritin for Microcytic Anaemia?

A

Low in iron deficiency

20
Q

What do we see on a Blood Film for Iron Deficiency Anaemia-related Microcytic Anaemia?

A

Microcytic
Hypochromic
Anisocytosis
Poikilocytosis

21
Q

What do we see on a Blood Film for Sideroblastic Anaemia related Microcytic Anaemia?

A

Dimorphic Blood FIlm

Hypochromic Microcytic cells

22
Q

What do we see on a blood film for Lead Poisoning related Microcytic Anaemia?

A

Basophilic stippling

23
Q

Why do we do Hb Electrophoresis for Microcytic Anaemia?

A

Checking for Hb variants and thalassemia

24
Q

What do we see for Sideroblastic Anaemia in the bone marrow ?

A

Ring sideroblasts

25
Q

Who do we do special investigations for in Microcytic Anaemia and when are they considered?

A

For Iron Deficiency Anaemia if > 40 yrs and post-menopausal women
Considered if there is no obvious cause of blood loss identified

26
Q

What special investigations do we do for this group of people in Microcytic Anaemia?

A

Upper GI Endoscopy
Colonoscopy
Haematuria

27
Q

What is the management plan for Iron Deficiency-related Microcytic Anaemia?

A

Oral iron supplements

28
Q

What is the management plan for Sideroblastic Anaemia-related Microcytic Anaemia?

A

Treat the cause
Pyridoxine used in inherited forms
Blood transfusion and iron chelation can be considered if there is no response to other treatments

29
Q

What is the management plan for Lead Poisoning-related Microcytic Anaemia?

A

Remove the source
Dimercaprol
D-penicillinamine

30
Q

What are the possible complications of Microcytic Anaemia?

A

High-output cardiax failure

Complications related to the CAUSE

31
Q

What is the prognosis for patients with Microcytic Anaemia?

A

Depends on cause