Anaemia Flashcards
(27 cards)
How is anaemia broadly defined
Hb level less than 13 in men and less than 12 in women
What are the 3 microcytic anaemias
iron deficiency anaemia
anaemia of chronic disease
thalassaemia
What are some causes of iron deficiency anaemia
reduced uptake - IBD,malnutrition,coeliac
increased loss- GI malignancy , IBD, menstruation
increased demand - pregnancy
What are symptoms of IDA
fatigue
SOB
pallor
palpitations
atrophic glossitis
post-cricoid webs
angular stomatitis
koilonychia
What investigations are required
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
What is stepwise management for those with IDA
treat underlying cause
oral iron replacement
-Oral ferrous sulphate/fumarate
Iron-rich diet
What are some side effects of iron supplements
black stools, constipation and nausea
What is Anaemia of chronic disease
chronic disease state - infection, malignancy, diabetes, autoimmune disorders
What are some symptoms that someone with ACD may have
fatigue
pallor
SOB with physical activity
What investigations are required and what will the investigations show
FBC- low Hb
serum iron < 15
TIBC- low
ferritin - normal / high
blood film - starts normocytic then leads to microcytic
How do you manage ACD
treat underlying cause
What is thalassaemia
two types
alpha and beta
beta thalassemia major is most severe type
What is the epidemiology od beta thalassaemia
more likely to affect those of mediterranean origin
What is the epidemiology of alpha thalassemia
more common in asians
What is beta thalassemia major
absence of beta globin chains
chromosome 11
autosomal recessive trait
What are features of beta thalassemia major
presents in first year of life with failure to thrive and
hepatosplenomegaly
microcytic anaemia
HbA2 and HbF raised
HbA absent
What is management for beta thalassemia major
repeated transfusions
- however can lead to iron overload and result in organ failure
iron chelation therapy hence more important
DESFERRIOXAMINE
What is alpha thalassemia
2 separate alpha globin genes are located on each chromosome 16
What does the clinical severity of alpha thalassemia depend on
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
What are the 2 types of macrocytic anaemia
megaloblastic
normoblastic
What are causes of megaloblastic anaemia
vit B12 deficiency
folate deficiency
nutrietnst which are essential to DNA synthesis
What are causes of vit B12 deficiency
insufficient dietary intake
gastric pathology - pernicious anemia
small bowel pathology - ileal resection, IBD , malbsorption disorders
What are causes of folate deficiency
reduced dietray intake
increased metabolic demand- pregnancy , malignancy
malabsorption disorders
antifolate drugs
What are some antifolate drugs
phenytoin
methotrexate
trimethoprim
