Anaemia Flashcards
(41 cards)
1
Q
Blood donations tested for?
A
- ABO group and RhD type
Infection:
2
Q
Microcytic anaemia causes
A
- Iron deficiency
- Thalassaemia
- Anaemia of chronic disorder
3
Q
Normocytic anaemia causes?
A
- Acute blood loss
- Haemolysis
- Anaemia of chronic disorder
- Bone marrow infiltration
- Combined haematinic deficiency
4
Q
Macrocytic anaemia causes
A
- B12/folate deficiency
- Haemolysis
- Hypothyroidism
- Liver disease
- Alcohol excess
- Myelodysplasia
5
Q
Effect of the following on the RBC
- age,
- gender,
- altitude,
- smoking behaviour
- stage of pregnancy
A
- ageing –> suppressed bone marrow
- male post puberty higher than female
- Hb rises with altitude
- increased Hb
- increased RBC, but more plasma so looks diluted,
6
Q
Iron Deficiency Anaemia clinical features
A
- Angular stomatitis
- Glossitis
- Koilonychia
7
Q
Iron Deficiency Anaemia causes?
A
- Dietary (80% from meat, 20% from vegetables)
- Physiological (infancy, adolescence, pregnancy)
- Blood loss
- Malabsorption e.g. coeliac disease
8
Q
where is iron absorbed?
A
duodenum
9
Q
Anaemia of chronic disease causes?
A
- Chronic infection/inflammation
- Malignancy
- Uraemia
- Endocrine disorders
10
Q
Megablastic RBC features?
A
- RBC precursors are abnormally large because of impaired DNA synthesis
- cell grows, but doesnt divide
11
Q
Causes of megablastic RBC?
A
- Vit B12 deficiency
- folic acid deficiency
12
Q
Where vit b12 stored?
A
liver
13
Q
where vit b12 synthesised
A
by micro-organisms: only
present naturally in animal produce
14
Q
how vit b12 gets absorbed?
A
- combines with intrinsic factor secreted by gastric parietal cells and
absorbed in terminal ileum.
15
Q
Cause of vit b12 deficiency?
A
- Dietary: veganism, rare
- Intrinsic factor deficiency: Pernicious anaemia
- Intestinal malabsorption:
- Disease of terminal ileum e.g. Crohns
- Blind loops & small bowel diverticulae
16
Q
Clinical features of vit b12 deficiency ?
A
- Anaemia
- Jaundice
- Glossitis
- Neurological deficit (don’t get this with folic acid deficiency)
17
Q
Management of vit b12 anaemia?
A
I. Vitamin B12 replacement as IM injection most common – 3x per week for 2 weeks then maintenance phase.
II. Oral folic acid replacement.
18
Q
Why replace vit b12 before folic acid?
A
- risk subacute combined degeneration of the cord (with permanent neurological
sequelae) if folic acid replaced in absence of vitamin B12.
Replace B before F!
19
Q
Source of folic acid?
A
Dietary sources:
- green vegetables,
- liver,
- nuts,
- cereals.
20
Q
Folic acid absorbed in?
A
jejenum
21
Q
Causes of folic acid deficiency?
A
- Dietary common in elderly, poor diet related to alcohol misuse.
- Increased utilisation e.g. in pregnancy,
- Malabsorption e.g. coeliac disease.
- Drugs e.g. anticonvulsants.
- Excessive loss e.g. renal dialysis
22
Q
Normal RBC life span?
A
120 days
23
Q
2 types of thalassaemia
A
- Alpha Thalassaemia
- Beta Thalassaemia
24
Q
3 types of beta thalasaemia?
A
- Beta Thalassemia trait (carrier) : Asymptomatic, normal life span
- Beta Thalassemia intermedia
- Variable phenotype and life span - Beta Thalassemia major
- Early death if untreated
25
Β thalassaemia major def?
Complete absence of HbA
26
Consequence of Β thalassaemia major
- Excess α chains accumulate and damage RBC
- Ineffective erythropoiesis
- Excessive RBCs Destruction
27
Long term B thalasaemia major consequence?
- Iron Overload
| - Extra-medullary hematopoiesis
28
Sx of Beta thalassaemia major?
1. Symptomatic anaemia in first few months of life.
2. Jaundice
3. Growth retardation
4. Bony abnormalities especially of the facial bones.
5. Enlarged
spleen and liver
29
Treatment of β Thalassaemia major
1. Regular blood transfusions (Life long)
2. Iron chelation e.g. Desferrioxamine, Deferiprone, Deferasirox
3. Folic acid
4. Bone marrow transplantation in early life
30
Alpha Thalasaemia def
- deficient/absent alpha subunits
- Excess beta subunits
- Excess gamma subunits newborns
31
Alpha Thalasaemia types?
1. Trait: 2 genes not working
2. Hemoglobin H Disease: 3 genes not working
3. Major (Hemoglobin Bart’s): ALL 4 not working
32
Hemoglobin H (HbH) disease thalasasemia clinical features
- jaundice,
- hepatosplenomegaly,
- leg ulcers,
- gallstones
33
Hemoglobin H (HbH) disease thalasasemia management
folic acid,
transfusions,
splenectomy
34
Hb Barts hydrops
- no alpha chains produced, Mainly gammma chains
| - Intrauterine death and stillborn
35
Life span of sickle cell?
Lives for 20 days or
| less
36
3 complications of sickle-cell anaemia
1. haemolysis
2. vaso-occlusion
3. hyposplenism
37
HbSS (sickle cell anaemia) increases the chance of getting which conditions?
Acute chest syndrome,
PE,
infection
38
What are HbSS different complications in various age?
- Ischaemic: more common in children and older adults, and lowest in
adults aged 20 to 29 years
- Haemorrhagic: most frequent in the 20- to 29-year age group
39
Emergency mx of HbSS?
reduction of HbS% by transfusion
40
Sickle cell trait (HbAS)
- Usually asymptomatic
| - Inability to concentrate urine (Occasionally renal papilliary necrosis)
41
Sickle cell solubility test
- The sickle cell solubility test relies on the relative insolubility of HbS in concentrated phosphate buffers compared to Hb A
and other Hb variants.
- Hb S precipitates causing a cloudy solution
