Anaemia

Question 1

Define anaemia

Answer 1

insufficient red cell mass to adequately deliver sufficient oxygen to peripheral tissues

Question 2

symptoms of anemia

give at least 10 example

Answer 2

• yellow eyes
• pale, cold and yellow skin
• shortness of breath
• weakness
• changed stool color
• fatigue
• dizziness
• fainting
• low blood pressure
• palpitations
• rapid heart rate
• chest pain
• angina
• heart attack
• enlargement in the spleen

Question 3

state the mechanisms of anaemia

Answer 3

oxygen transport
v
production of erythropoeitin
v
RBC production
v
Haemoglobin concentration

Question 4

what is a microcytosis and what condition can it cause?

Answer 4

decrease in size of erythrocytes

indicative of

• anaemia
• thalassaemia
• hyperthyroidism

Question 5

what is macrocytosis and what it result from?

Answer 5

increase in the size of erythrocytes

found in B12 deficiency

result of certain prescription drugs

Question 6

hypochromia

Answer 6

deficiency of colouration of cells, which caused by a deficit of Hb

Question 7

What is the use of anisochromia?

Answer 7

used to determine the increased variability of staining

Question 8

how to diagnosis anaemia

Answer 8

to check on the patient’s reticulocyte response either positive / negative ( the inflammation response from various changes of the tissue cells)

Question 9

what if MCV < 75fl?

Answer 9

investigate for Fe deficiency

Question 10

What if MCV > 100fl

Answer 10

Investigate for the vitamin B12 deficiency

Question 11

What if MCV 75-100fl

Answer 11

investigate for anaemia of chronic disorder

Question 12

What to check if the reticulocyte response was positive?

Answer 12

investigate for bleeding / haemolytic anaemia

Question 13

what is the dietary recommendation for iron daily intake?

Answer 13

2mg

Question 14

what regulates iron absorption into the ciruculation?

Answer 14

Hepcidin

Question 15

How does hepcidin regulates iron absorption?

Answer 15

it inhibits the protein ferroportin which pumps out the iron

–> reduce the iron level

Question 16

where is iron absorbed?

Answer 16

duodenum

Question 17

what is transferrin?

Answer 17

Beta-globulin protein that can carry 2 Fe3+ ions per molecule

Question 18

Which 2 forms is iron stored in?

Answer 18

Haemosiderin

Ferritin

Question 19

how haemosiderin be visualised?

Answer 19

perl’s stain

Question 20

why people develop iron deficiency?

Answer 20

decreased supply of Fe

Increased requirement for Fe

Question 21

symptoms of Fe deficiency

Answer 21

Glossitis - smooth, inflamed tongue

Koilonychia - spooning fingernails

Angular stromatitis - lesion at the corner of the mouth

Pica

behavioural difficulties

Question 22

Treatment for Fe deficiency

Answer 22

Dietary changes

Iron supplementation

Question 23

Macrocytic and megaloblastic

Answer 23

Macrocytic –> large erythrocytes and found in many conditions.

Megaloblastic –> reserved to describe macrocytosis duo to retardation in DNA synthesis

Question 24

2 uses of vitamin B12 metabolic pathways

Answer 24

Conversion of l-methylmalonyl coenzyme a to succinyl co-enzyme A

methylation of homocysteine to methionine

Question 25

where is Vitamin B12 absorbed?

Answer 25

terminal ileum

Question 26

two carrier protein that have a transporter role in Vitamin B12 homeostasis

Answer 26

- Transcobalamin I | - Transcobalamin II

Question 27

2 important folates

Answer 27

N-5,10-methyleneTHF N-5-methyleneTHF

Question 28

What is folates?

Answer 28

chemical belonging to the folic acid family

Question 29

role of folate

Answer 29

act as single carbon donors/acceptors in a variety of reaction ``` synthesis of methionine histidine catabolism converts serine to glycine purine synthesis pyrimidine synthesis ```

Question 30

where does folate stored in the body

Answer 30

liver

Question 31

diet consumption of folate

Answer 31

700ug of folate per day with heat labile

Question 32

Where is the folate absorption in?

Answer 32

upper jejunum

Question 33

what is the process that folate need to do before getting absorbed

Answer 33

polyglutamate must be converted to monoglutamates e.g. folic acids --> N-5-methyleneTHF which circulates freely in the blood

Question 34

what are essential for the process of producing mature nucleotides?

Answer 34

folate and vitamin B12

Question 35

deficiency in vitamin B12 can arise from

Answer 35

inadequate dietary intake malabsorption increased requirements failure of utilisation

Question 36

folate deficiency can cause from

Answer 36

inadequate dietary intake malabsorption --> crohn's disease drug-induced folate deficiency

Question 37

symptoms of megaloblastic anemia

Answer 37

``` weak muscles numbness or tingling in hands and feet nausea decreased appetite weight loss irritability lack of energy or tiring easily diarrhoea increased heart rate stomatitis glossitis jaundice ```