Acquired anaemia

Question 1

What are the 3 types of anaemia?

Answer 1

Hypochronic mycrocytic
Normochronic normocytic
MAcrocytic

Question 2

What investigations are done to determine what kind of anaemia?

Answer 2

FBC- Hb and MCV

Question 3

What investigation is used in hypo chromic microcytic anaemia?

Answer 3

Serum ferritin

Question 4

What would a low serum ferritin in hypochromic microcytic signify?

Answer 4

Iron deficiency anaemia- most common type

Question 5

What are causes of iron deficiency anaemia?

Answer 5

Bleeding= most common- GI, menorrhagia
Diet- malabsorption
Increased requirement- pregnancy

Question 6

What is the management of iron deficiency anaemia?

Answer 6

Treat cause
Oral iron- IV if intolerant
Rare= blood transfusion

Question 7

What would cause hypo chromic microcytic with a normal/high serum ferritin?

Answer 7

Thalassaemia

Anaemia of chronic disease

Question 8

What investigation is used to differentiate normochromic normocytic anaemia?

Answer 8

Reticulocyte count

Question 9

What would a high reticulocyte count in normochromic normocytic anaemia signify?

Answer 9

Acute blood loss

Haemolysis

Question 10

What would a normal/low reticulocyte count in normochromic normocytic anaemia signify?

Answer 10

Anaemia of chronic disease

Question 11

Why are reticulocytes elevated in haemolytic anaemia?

Answer 11

Accelerted RBC destruction compensated by bone marrow

Question 12

What are the causes of haemolytic anaemia?

Answer 12

Congenital- G6PD, sickle cell, thalassaemia, spherocytosis

Acquired- autoimmune, transfusion reaction, haemolytic disease of the newborn, prosthetic valve related

Question 13

What investigation is done if reticulocytes are increased?

Answer 13

Investigate for acute blood loss

Direct antiglobulin test DAGT

Question 14

What would a + DAGT test signify?

Answer 14

Immune cause of haemolysis

Question 15

What would a - DAGT signify?

Answer 15

Non immune cause

Question 16

What would cause a + warm autoantibody?

Answer 16

Usually autoimmune most commonly idiopathic

Other causes- drugs, CLL

Question 17

What would cause a + cold autoantibody?

Answer 17

Usually secondary- infection, neoplasm

Occasionally CHAD

Question 18

Would would cause a + alloantibody?

Answer 18

Transfusion reaction

Question 19

What would cause a - DAGT?

Answer 19

Non immune causes e.g. severe infection, DIC, toxins, drugs, pre-eclampsia

Question 20

What investigation is done of macrocytic anaemia?

Answer 20

B12/folate assay

Question 21

What would a megaloblastic anaemia be caused by?

Answer 21

B12 or folate deficiency?

Question 22

What are the causes of B12 deficiency?

Answer 22

Pernicious anaemia

Gastric/ileal disease

Question 23

What is pernicious anaemia?

Answer 23

Autoimmune, common cause of B12 defieicny

Present with lemon yellow tinge

Question 24

What causes folate deficiency?

Answer 24

Dietary
Increased requirement e.g. haemolysis
GI

Question 25

What is the management of B12/folate deficiency?

Answer 25

B12 IM injection every 3 months | Oral folate

Question 26

What causes non-megaloblastic macrocytic anaemia?

Answer 26

Myelodysplasia Drugs- esp alcohol Marrow infiltration

Question 27

What is anaemia of chronic disease?

Answer 27

Normochronic normocytic or slightly hypo chromic microcytic anaemia Inflammation induced reduction in RBCs

Question 28

What is the mechanism of anaemia of chronic disease?

Answer 28

Inflammation --> hepcidicn production --> decreased iron absorption --> decreased plasma iron --> decreased RBC production

Question 29

What causes anaemia of chronic disease?

Answer 29

Chronic infection- TB, HIV, hepatitis Malignancy Connective tissue disease- RA, SLE, IBD