ANAEMIA Flashcards
(31 cards)
What is haematopoiesis?
The production of circulating blood cells from stem cells in bone marrow. It gives rise to erythrocytes, platelets, and leukocytes.
Where does haematopoiesis occur?
Bone marrow
In fetal development: liver, spleen
Stimulated by cytokines like GM-CSF, G-CSF, M-CSF
What are haematopoietic growth factors?
Glycoproteins regulating progenitor cell differentiation and proliferation:
EPO: RBCs (produced in kidneys)
TPO: Platelets (liver, bone marrow)
Interleukins: All progenitors
What is included in a full blood count (FBC)?
WCC (white cells)
RCC (red cells)
Hb (haemoglobin)
MCV (mean cell volume)
Platelet count
Define anaemia.
A condition where RBC number or Hb concentration is below normal, reducing oxygen-carrying capacity.
What are the classifications based on MCV?
Microcytic (<80 fL)
Normocytic (80–100 fL)
Macrocytic (>100 fL)
Functional classifications of anaemia?
Deficiency (iron, B12, folate)
Hypoproliferative
Hemolytic
Aplastic
What are the causes of iron deficiency anaemia?
Inadequate intake/absorption
Increased demand (pregnancy, growth)
Chronic bleeding
Diagnostic findings of iron defiiciency anaemia?
↓ Hb
↓ Serum iron
↓ Ferritin
↑ TIBC (total iron binding capacity)
Symptoms of iron deficiency anaemia?
Fatigue
Brittle hair, koilonychia
Pica (appetite for non-food)
Glossitis
Angular stomatitis
Plummer-Vinson Syndrome
How do B12 and folate contribute to haematopoiesis?
They are crucial for DNA synthesis. Deficiency leads to impaired cell division → megaloblastic anaemia.
Causes of vitamin B12 deficiency?
Lack of intrinsic factor (pernicious anaemia)
Malabsorption
Gastric acid deficiency
Causes of folate deficiency?
Inadequate intake
Pregnancy
Alcoholism
Malabsorption
Drugs (e.g., methotrexate)
Why must you confirm B12 status before giving folate?
Folate can correct anaemia, but B12 deficiency–related neurological defects will persist or worsen
Treatment of folate deficiency? (megaloblastic anaemia)
B12: IM cyanocobalamin
Folate: 1 mg PO daily
Avoid folate-only therapy if B12 not corrected.
What causes anaemia of inflammation (AI)?
Chronic infection, inflammation, malignancy
Excess cytokines
Blunted EPO response
↑ Hepcidin → ↓ iron absorption/release
Lab features of anaemia of inflammation?
Normocytic, normochromic
↓ Serum iron
Normal or ↑ ferritin
↓ TIBC
Management of Anaemia of Inflammation?
Treat underlying disease
Iron only if transferrin saturation < 20%
ESAs (erythropoietin stimulating agents): if due to CKD, HIV, malignancy
What are ESAs and how do they work?
Epoetin alfa, darbepoetin alfa
Stimulate erythropoiesis like natural EPO
Often need iron supplementation concurrently
AE: ↑ BP, nausea, fatigue
Monitor Hb; avoid >12 g/dL or >1g/dL rise in 2 weeks
What is haemolytic anaemia?
Premature RBC destruction. Can be drug-induced, autoimmune, or hereditary.
Features of haemolytic anaemia?
Fatigue, SOB, pallor
Reticulocytosis
+Coombs test (autoimmune)
Remove trigger to manage
Common triggers in G6PD deficiency? (in haemolytic anaemia)
Primaquine/chloroquine
Sulfa drugs
Nitrofurantoin
chloramphenicol
high-dose aspirin
cotrimoxazole
salazopyrin
dapsone
Triggers in patients with normal G6PD? (in haemolytic anaemia)
Methyldopa
Dapsone
Penicillin (high doses)
What is aplastic anaemia?
Pancytopenia from bone marrow stem cell failure
May be drug-induced, inherited, or immune-mediated
High mortality (~50%)
