What does spherocytes on the blood film mean possibly?
Warm haemolytic anaemia
Which part of the Hb is affected in thalessemia?
What are pencil cells?
A feature of iron deficiency anaemia
(Not in thalessemia)
Will an upper GI bleed cause a positive faecal occult blood test?
What is diagnostic test for thalassemia?
What are some causes of microcytic anaemia?
What is the RDW in Fe deficiency and thal minor?
Fe - elevated
Thal - normal
What is a systematic way to classify causes of anaemia?
How long do B12 stores last?
In terms of the classification of anaemia's, what types of anaemia is Fe deficiency anaemia?
Does the urine go dark in haemolysis?
Generally no as it won't pass through the glomerulus
How long does the folate stores last?
What is the next test to be performed with spherocytes are seen? How is it interrupted?
Direct combs test
- Positive: warm haemolytic anaemia
- Negative: hereditary spherocytosis
What is the Ix reticulocyte count useful for?
Determining the function of the bone marrow
Where is Fe absorbed? How much can be absorbed per day?
1mg per day
What is the size of cells in folate and B12 deficiency?
What is the most common cause of Fe deficiency in Australia?
Occult blood loss from the GIT
In haemolysis, is the bilirubin conjugated or unconjugated?
Why might the platelets be up in a patient with fatigue?
Platelets can be elevated in Fe deficiency anaemia
A inflammatory process might be elevating the platelets
What abnormal cells might be seen in thalassemia?
What does a leukoerythroblastic picture in peripheral blood reflect?
Bone marrow invasion pushing bone marrow precursors into the peripheral blood
What do you look for on blood film in haemolysis?
Spherocytes = warm autoimmune anaemia or hereditary spherocytosis
Fragments + Schistocytes = microangiopathy
Bite cells + blisters = oxidative damage
What is the red cell distribution width (RDW)?
The width of the peak of the standard deviation of the RBC number and MCV
What are the five signs of haemolytic anaemia
Abnormal blood film
Raised lactate dehydrogenase
Raised reticulocyte counts
Raised unconjugated bilirubin
What must you be wary of when looking at the ferritin in iron studies?
It's an acute phase reactant therefore may be inappropriately normal
What test will measure long term folate levels?
Red cell folate
What causes decreased RBC production?
Anaemia of chronic disease
Low haematinitcs - Folate, B12, iron
Bone marrow failure
Endocrine disorders - Thyroid, low EPO
Infectious eg TB, HIV