Anaemia

Question 1

Causes of microcytic anaemia

Answer 1

TAILS
Thalassaemia 
Anaemia of chronic disease 
Iron deficiency anaemia 
Lead poisoning 
Sideroblastic anaemia

Question 2

Causes of normocytic anaemia

Answer 2

3 As and 2 Hs
Acute blood loss 
Anaemia of chronic disease 
Aplastic anaemia 
Haemolytic anaemia 
Hypothyroidism

Question 3

Macrocytic anaemia is divided into:

Answer 3

Megaloblastic anaemia

Normoblastic macrocytic anaemia

Question 4

Causes of megaloblastic anaemia

Answer 4

Caused by vitamin deficiency –> impaired DNA synthesis so instead of the cell dividing normally it gets bigger and becomes an abnormal cell

B12 deficiency
Folate deficiency
Anti-folate drugs e.g. methotrexate, phenytoin
Cytotoxics - hydroxycarbamide

Question 5

Normoblastic macrocytic anaemia is caused by:

Answer 5

Alcohol 
Liver disease
Hypothyroidism
Reticulocytosis - usually from haemolytic anaemia or blood loss
Myelodysplasia
Drugs e.g. azathioprine

Question 6

Symptoms of anaemia

Answer 6

Tiredness
Dizziness/ syncope 
SOB
Headaches 
Palpitations 
Worsening of other conditions e.g. heart failure or peripheral vascular disease

Question 7

Symptoms specific for iron deficiency anaemia

Answer 7

Pica - cravings for abnormal things e.g. dirt

Hair loss = iron deficiency anaemia

Question 8

Signs of anaemia

Answer 8

Pallor
Conjunctival pallor
Tachycardia
Raised respiratory rate

Question 9

Signs of specific causes of anaemia

Answer 9

Koilonychia - spoon shaped nails - iron deficiency anaemia
Angular chelitis = red sores in corners of mouth - iron deficiency
Atrophic glossitis = smooth tongue - iron deficiency
Brittle hair/ nails = iron def
Jaundice - haemolytic anaemia
Bone deformities - thalassaemia
Oedema, hypertension & exocoriations on the skin - chronic kidney disease

Question 10

Investigations for anaemia

Answer 10

FBC
MCV
Ferritin
Folate 
B12 
Blood film 
OGD - too look for causes of acute bleeding
Bone marrow biopsy - if cause unclear