Anaemia Flashcards by Karen Bourns

Anaemia refers to

not enough red cells

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Pancytopenia

not enough of all cells - RBC WBC and platelets

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Leukopaenia

not enough white cells

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Neutropaenia

not enough neutrophils

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Lymphopaenia

not enough lymphocytes

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Thrombocytopaenia

not enough platelets

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Polycythaemia

too many red cells

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Leukocytosis

too many white cells

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Thrombocytosis

too many platelets

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Dyserythropoiesis

dysfunctional red cells

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White cell function defect

dysfunctional white cells

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Platelet function defect

dysfunctional platelets

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What is measured to determine anaemia?

Hb rather than red cell count

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Anaemia is defined as

Hb level below that which is normal for age and sex

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What determines the need for transfusion?

how long they can maintain O2 delivery and what kind of stress their heart is under to do so (and how they can cope)

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The first step in assessing a patient with anaemia is

ASSESS HR!!

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Anaemia can result in reduced oxygen to tissues unless _______ comoensates

CO increases to compensate

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T/F SV can increase to compensate for anaemia

True in cases of dietary iron deficiency where the anaemia progresses over a long time

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Acute onset anaemia presents with

increased HR

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Clinical signs of anemia include

Pale
Lethargic
Failure to thrive (chronic in children)
Hypoxic
Ischaemia
Tachycardia

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What are common behavioural signs of hypoxia?

distressed, thrashing, not making sense, odd behaviour, disorientation, confusion

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Hypoxia is an indicator of anaemia; what is an example?

Hypoxic behaviour in a child with congenital heart disease - his Hb is 140 which would be normal BUT he is compensating for the 70% O2 sat due to his congenital heart disease - therefore his normal Hb is 200 and an Hb of 140 is anaemia in this patient

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Anaemia can complicate

coronary artery disease, causing stroke; carotid disease, causing stroke - both have compromised tissue O2 delivery

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What are the causes of anemia?

Failure of production
Increased destruction/loss
Inappropriate production

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What are the clinical investigations in anaemia?

FBE (for Hb) w/blood film

MCV

mean corpuscular volume

MCH

mean corpuscular Hb

Blood film tells us about

morphology of RBCs, WBCs, and platelets

Normocytic

normal sized red cells

Microcytic

small red cells

Macrocytic

large red cells

Normochromic

normal colour red cells

Hypochromic

not enough Hb in red cell

Polychromatic

immature RBC with retained RNA - being pushed out of BM before it is ready

How is anaemia clinically classified?

loss/destruction vs. failure | micro/normo/macrocytic (if BM problem)

If anaemia is due to loss or destruction (BM working overtime), Hb declines

rapidly; need to act quickly

If anaemia is due to BM failure (not working), Hb declines

Hb drops ~1g/week; time to work out why

Morphological description of red cells is used when anaemia is due to

BM problem

Signs of increased red cell production include

increased reticulocytes (polychromatic) in peripheral blood

Signs of increased red cell destruction include

jaundice due to increased serum bilirubin; haptoglobins and LDH

Signs of anaemia due to blood loss

on Hx and examination - is it overt or covert

What are the two important causes of anaemia due to increased destruction and loss of red cells?

Blood loss and haemolysis

Haemolysis is due to causes either ______ or _______ to the red cell

internal or external

Causes of haemolysis internal to the red cell affect

membrane, enzyme (G6P), or Hb

Causes of haemolysis internal to the red cell are a result of

immune mediated, mechanical, or infection

Failure of blood cell production is due to

Lack of haematinics Marrow failure or suppression Marrow invasion

Microcytic anaemia is due to

iron deficiency or thalassaemia, rarely lead poisoning, seroblastic anaemia

If there is a microcytic anaemia, what needs to be determined?

is it a dietary deficiency in iron or is their blood loss eg colon cancer in an adult

Macrocytic anaemia is due to

B12 or folate deficiency; liver disease, inherited BM failure syndromes, dyserythropoieses, drugs

Bone marrow is investigated by

aspirate and smear | trephine coring biopsy - histo specimen

Bone marrow aspirate tells us about

morphology of cells eg for laeukaemia

Trephine of bone marrow tells us about

architecture of BM eg for tumours (patches of abnormal cells)

Tx of anaemia

cause specific - replace dietary deficiencies, stop haemolysis or causative drug use, transfusion

ABO genes are on chromosome __ whereas H genes are on chromosome __

9, 19

Blood group antigens are located

on the surface of RBCs - define blood group

The precursor substance on red cells is

H substance - depending on genes, converted to A, B, AB, or O antigen

The H gene encodes for ________ which converts ____ to ____________

H transferase; PS to H Ag

ABO genes encode for ______ which __________

transferase enzymes which add sugars to the H substance, determining the blood group ie A codes for A, converts H to A

Most common blood groups are

A and O (30-40%; B only 11%)

The least common blood type is

AB (3%)

Rh antigens include

C, c, D, E, e

Genes for Rh Ag are on chromosome

Rh+ means

D positive (DD, Dd)

Rh- means

D negative (dd)

Rh positivity differs with

``` ethnicity: Chinese 100% European 84% West African 95% Australian 98% ```

Blood group antibodies are

``` Naturally occurring: A has anti-B Abs B has anti-A Abs AB has none O has both anti-A and anti-B Abs ```

ABO antibodies are ________ while Rh antibodies are _______

ABO are naturally occurring whereas Rh are induced by exposure

Exposure to Rh Ag occurs

via blood transfusion or during pregnancy

Rh group antibodies are

induced by exposure

Rh- mum carrying an Rh+ baby, what happens if the blood crosses the placenta?

Mum gets immunized and makes Rh+ Abs that attack the Rh+ red cells in the fetus - haemolytic disease of the newborn

Haemolytic disease of the newborn occurs when

anti-Rh+ Abs are generated to an Rh- mum reacting to blood from an Rh+ baby; destroy fetal RBCs

Haemolytic disease of the newborn is treated with

anti-D

T/F cells and plasma have the same blood group compatabilities

False; cells and plasma have opposite compatabilities

A blood can receive blood from

A or O

B blood can receive blood from

B or O

AB can receive blood from

anyone

O blood can receive blood from

O only

Which blood type is considered the universal donor?

Which blood type is considered the universal recipient?

Rh+ blood can receive blood from

Rh+ or Rh-

Rh- blood can receive blood from

Rh -ve only

Anaemia Flashcards

(81 cards)