Anaemia

Question 1

Causes of microcytic anaemia

Answer 1

Iron deficiency

Thalassaemia

Congenital sideroblastic anaemia

Lead poisonning

Question 2

Management of microcytic anaemia

Answer 2

Treat underlying cause

Ferrous sulphate if iron deficiency (causes constipation)

Blood transfusions very rarely necessary

Question 3

Pernicious anaemia pathophysiology

Answer 3

Antibodies to intrinsic factor +/- gastric parietal cells

Intrinsic factor antibodies bind to intrinsic factor and block B12 binding site

Gastric parietal cell antibodies reduce acid production and atrophic gastritis

Question 4

Pernicious anaemia

Answer 4

More common in females

Associated with other autoimmune diseases

Features
- lethargy, pallor, dyspnoea
- peripheral neuropathy, subacute combined degeneration of spinal cord
- neuropyschiatric features
- mild jaundice, glossitis

Increased risk of gastric cancer

Question 5

Pernicious anaemia management

Answer 5

IM B12

More frequent doses if neurological features present

Folic acid supplementation may be required

Question 6

Causes of normocytic anaemia

Answer 6

Anaemia of chronic disease

CKD

Aplastic anaemia

Haemolytic anaemia

Acute blood loss

Question 7

Macrocytic anaemia causes

Answer 7

Vitamin B12 deficiency

Folate deficiency

Secondary to methotrexate