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Clinical haematology > Anaemia > Flashcards

Anaemia Flashcards

1
Q

How is anaemia broadly defined

A

Hb level less than 13 in men and less than 12 in women

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2
Q

What are the 3 microcytic anaemias

A

iron deficiency anaemia
anaemia of chronic disease
thalassaemia

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3
Q

What are some causes of iron deficiency anaemia

A

reduced uptake - IBD,malnutrition,coeliac

increased loss- GI malignancy , IBD, menstruation

increased demand - pregnancy

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4
Q

What are symptoms of IDA

A

fatigue
SOB
pallor
palpitations
atrophic glossitis
post-cricoid webs
angular stomatitis
koilonychia

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5
Q

What investigations are required

A

FBC- hypochromic microcytic anaemia

blood film-
pencil cells, anisopoikilocytosis
hypochromic
microcytic
target cells

Serum ferritin - LOW

TIBC/transferrin- high– due to less iron being bound

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6
Q

What is stepwise management for those with IDA

A

treat underlying cause

oral iron replacement
-Oral ferrous sulphate/fumarate

Iron-rich diet

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7
Q

What are some side effects of iron supplements

A

black stools, constipation and nausea

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8
Q

What is Anaemia of chronic disease

A

chronic disease state - infection, malignancy, diabetes, autoimmune disorders

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9
Q

What are some symptoms that someone with ACD may have

A

fatigue
pallor
SOB with physical activity

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10
Q

What investigations are required and what will the investigations show

A

FBC- low Hb
serum iron < 15

TIBC- low

ferritin - normal / high

blood film - starts normocytic then leads to microcytic

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11
Q

How do you manage ACD

A

treat underlying cause

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12
Q

What is thalassaemia

A

two types
alpha and beta
beta thalassemia major is most severe type

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13
Q

What is the epidemiology od beta thalassaemia

A

more likely to affect those of mediterranean origin

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14
Q

What is the epidemiology of alpha thalassemia

A

more common in asians

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15
Q

What is beta thalassemia major

A

absence of beta globin chains
chromosome 11

autosomal recessive trait

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16
Q

What are features of beta thalassemia major

A

presents in first year of life with failure to thrive and
hepatosplenomegaly

microcytic anaemia

HbA2 and HbF raised

HbA absent

17
Q

What is management for beta thalassemia major

A

repeated transfusions
- however can lead to iron overload and result in organ failure

iron chelation therapy hence more important

DESFERRIOXAMINE

18
Q

What is alpha thalassemia

A

2 separate alpha globin genes are located on each chromosome 16

19
Q

What does the clinical severity of alpha thalassemia depend on

A

number of alpha globulin alleles affected

-1/2 affected - blood film is hypochromic and microcytic
Hb level is normal

3 affected -
hypochromic microcytic anaemia with splenomegaly . Hb H disease

4 - death in utero

20
Q

What are the 2 types of macrocytic anaemia

A

megaloblastic
normoblastic

21
Q

What are causes of megaloblastic anaemia

A

vit B12 deficiency
folate deficiency

nutrietnst which are essential to DNA synthesis

22
Q

What are causes of vit B12 deficiency

A

insufficient dietary intake
gastric pathology - pernicious anemia
small bowel pathology - ileal resection, IBD , malbsorption disorders

23
Q

What are causes of folate deficiency

A

reduced dietray intake
increased metabolic demand- pregnancy , malignancy
malabsorption disorders
antifolate drugs

24
Q

What are some antifolate drugs

A

phenytoin

methotrexate

trimethoprim

25
Q

what can B12 deficiency cause

A

sub-acute combined cord degeneration

loss of proprioception and vibration
absent jerk reflexes and peripheral neuropathy

26
Q

How do you treat megaloblastic anaemia

A

replace vit B12 FIRST !!

then folate

27
Q

What are some causes of normoblastic anaemia

A

alcohol
liver disease
hypothyroidism
pregnancy
reticulocytosis
myelodysplasia

drugs- AZATHIOPRINE

Clinical haematology (5 decks)

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