Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Cardio > Anaemia > Flashcards

Anaemia Flashcards

(60 cards)

Start Studying
1
Q

What is shown by an increase in unconjugated bilirubin

A

prehepatic/hepatic jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does bilirubin become conjugated

A

Bilirubin in the blood is bound to albumin (unconjugated). It is converted to conjugated bilirubin when entering the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some of the complications associated with a higher bilirubin?

A

Jaundice, Obstructive gall stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is hereditary spherocytosis?

A

Inherited disruption of vertical linkages in RBC cell membrane (ankyrin), -> spherocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What blood cells would you see in a blood film of hereditary spherocytosis?

A

Spherocytes, Cells with no central pallor, Reticulocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why would you see reticulocytes in a blood film?

A

Compensatory effect - as more blood cells get destroyed, early forms of rbcs (reticulocytes) are released from the bone marrow prematurely to do some of the oxygen delivering

seen as polychromatic (blue tinge) cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What causes raised bilirubin

A

RBC breakdown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is haemolysis

A

^ destruction of RBC

due to intrinsic RBC abnormality
due to extrinsic factors acting on RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is haemolytic anaemia

A

Haemolysis -> red. Hb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How to treat haemolytic anaemia

A

Folic acid (aid rq for erythropoeisis)
Splenectomy (^RBC lifespan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Presentation of px with conjugated bilirubin

A

Pigment gallstones
Obstructive jaundice - block common bile duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Difference btw unconjugated and conjugated bilirubin

A

Unconjugated bilirubin:
insoluble in blood - bound to albumin
Pre-hepatic jaundice
Toxic (to the brain)
Cannot be excreted via urine

Conjugated bilirubin:
Water soluble
small amounts loosely bound to albumin
post-hepatic jaundice (issues w/ bile duct/gallbladder)
Relatively non-toxic
Excreted in urine -> dark

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mechanism of anaemia
PPLS

A

Production (red. RBC/Hb prod by the bone marrow)
Pooling (Splenomegaly)
Loss of blood from the body
Survival (haemolysis).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is DAT and how does it work

A

Direct Antiglobulin test
In solution coloured rabbit AB to identify whether blood contains autoantibodies (binds autoAB)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does AIHA stand for and what are its causes

A

Autoimmune Haemolytic anaemia
idiopathic, SLE, lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What lab evidence would point towards haemolysis

A

^ LDH (lactate dehydrogenase)
Unconjugated hyperbilirubinemia (show prehepatic issue)
red. haptoglobulins (breakdown free Hb in liver)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the bone marrows response to haemolysis

A

Reticulocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What causes aq haemolytic anaemia (HA)

A

Defect in the RBC environment (plasma, vasculature)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Non-immune environmental factors leading to aq HA

A

Haemolytic uraemic syndrome - AKI
Malaria - microbe
Snake venom
drugs - oxidant damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Immune mediated factors leading to aq HA

A

Autoimmune
Alloimmune (post transfusion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How can you differentiate between AIHA and hereditary spherocytosis?

A

DAT test - positive in AIHA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What inherited defects can affect RBC

A

Hereditary spherocytosis - membrane
Sickle cell anaemia - Hb
G6PD deficiency - Pentose shunt dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the purpose of the HMP Shunt?

A

Forms Glutathione and protects RBC from oxidant damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What enzyme is critical in the HMP shunt that if deficient can lead to haemolytic anaemia?

A

G6PD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What can you see in a blood film for someone with G6PD deficiency?
Evidence of oxidant damage: Bite cells w/ no central pallor Heinz bodies - denatured Hb Ghost cells
26
What does the presence of ghost cells show?
Intravascular Haemolysis
27
What advice would you give patients with G6PD deficiency?
Avoid oxidant drugs, broad beans, naphthalene (in cigarette smoke), protect against infection
28
Two types of HA
Inherited HA - abnormal membrane/Hb/enzymes Acquired HA - extrinsic factors: microbes/chemicals/drugs
29
Where are the two locations that haemolysis can occur?
Intravascular - within blood vessels (acute damage to RBC) Extravascular - in spleen or liver (due to removal)
30
What evidence would point towards HA
Morphologically abnormal RBC ^ RBC breakdown - ^bilirubin/red. haptoglobin ^ Bone marrow activity - ^MCV due to reticulocytes
31
Blood film abnormalities with iron deficiency anaemia
Microcytic (red. MCV) Hypochromic (red. MCHC) low ferritin/iron
32
Clinical signs of iron deficiency anaemia
Koilonychia - bent nails Glossitis - inflammation of the tongue Angular stomatitis - inflamed corners of the mouth
33
Causes of iron deficiency
^ loss - menstrual, GI insufficient iron - dietary, malabsoption (coeliac) ^ iron rq - pregnancy
34
What conditions cause microcytic anaemia
Haem Synthesis Defect (iron deficiency, chronic disease) Globin Synthesis Defect (alpha and beta thalassaemia)
35
What conditions lead to macrocytic anaemia?
B12 and folate deficiency Liver disease Drugs affecting DNA synthesis
36
What cells would be macrocytic and polychromatic?
Reticulocytes
37
What conditions lead to normocytic anaemia?
Recent blood loss - GI haemorrhage Bone marrow failure (leukaemia/chemo), Splenic Sequestration - hypersplenism
38
What are the symptoms of iron deficiency anaemia?
Tiredness, lethargy, breathlessness at rest, peripheral oedema
39
What is ferritin?
Stores of iron in the body
40
What is transferrin?
plasma transport protein
41
What is hepcidin?
Protein that inhibits Fe absorption/transport from the gut | released in response to xs ferritin suppressed by EPO
42
What questions would you ask someone with iron deficiency anaemia?
Diet (vegan), Gastrointestinal Symptoms (bowels, indigestion, dysphagia), Menstrual History, Weight Loss, Medication (NSAIDs)
43
How do you treat iron deficiency anaemia?
Iron Replacement Therapy (Ferrous Sulphate)
44
What is shown in the blood film with high ESR
Rouleaux - stacks of RBC (looks like coins) When plasma protein conc is high
45
What are some causes of anaemia of chronic disease?
Infections - TB, HIV Rheumatoid/ autoimmune Malignancy
46
How does chronic disease lead to anaemia?
Inflammatory responses ^ hepcidin production whilst also red. transferrin production -> less Fe abs from gut / high ferritin
47
What are the key differences in ferritin/transferrin/transferrin saturation between iron deficiency anaemia and anaemia of chronic disease?
IRON - low ferritin (high in chronic) / high transferrin (low in chronic) / low transferrin saturation (normal in chronic)
48
What is pernicious anaemia?
Anaemia from deficiency of vitamin B12
49
What is poikilocytosis?
Variation in RBC shape
50
What does the term megaloblastic anaemia refer to?
Macrocytic anaemia caused by B12 or folate deficiency
51
What is a megaloblast and what are the features of it?
Abnormal erythroblast in the bone marrow - macrocytic, asynchronous nucleocytoplasmic maturation. It is NOT a reticulocyte | nucleus hypersegmentation
52
What are B12/folic acid rq for
Dna synthesis
53
What are some causes of B12 deficiency?
Dietary, Gastric (gastrectomy, autoimmune), Bowel (Crohn's)
54
How would you treat each cause of b12 deficiency?
Dietary - oral supplements, Gastric & Bowel - IM Hydroxocobalamin Injection
55
What are some causes of folate deficiency?
Red. Availability (diet, malabsorption - coeliac) ^ Demand (pregnancy, haemolysis)
56
How would you treat these causes of folate deficiency?
Oral supplements
57
Neurological disorders associated with B12/folate deficiency
Vit B12- Dementia, spinal cord degeneration Folate - developmental neural tube defects
58
How does the body absorb B12
Cleared from food using HCL forms B12-IF (parietal cells) B12-IF absorbed into ileum where it binds receptors
59
How does the body absorb folic acid
Absorbed into the duo/jej of the SI
60

Cardio (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions