Anaemia

Question 1

what is normal Hb

Answer 1

121-166 g/L

Question 2

what is normal haematocrit

Answer 2

0.36-0.49

Question 3

what are the signs of anaemia

Answer 3

Fatigue
• Weakness
• Pale or yellowish skin
• Irregular heartbeats
• Shortness of breath – worse if underlying respiratory or
cardiac disease
• Dizziness or light-headedness
• Chest pain – worse if underlying arterial disease
• Cold hands and feet
• Headache

Question 4

how should you initially treat an adult with microcytic hypochromic anaemia

Answer 4

ferrous sulphate and refer for more tests

Question 5

how should you initially treat an adult with megaloblastic anaemia

Answer 5

send blood for b12 and folate levels

Question 6

what type of anaemia would you get due to blood loss

Answer 6

normochromic and normocytic (takes a few hours for the plasma to expand in response to blood loss so anaemia is not picked up straight away)

Question 7

how could you treat normocytic normochromic anaemia

Answer 7

transfusion if symptomatic or ferrous sulphate (1000mls of blood loss means loss of 500mg of iron)

Question 8

what type of blood disorder does alcohol excess cause

Answer 8

macrocytosis

Question 9

what causes normochromic normocytic anaemia

Answer 9

acute blood loss
anaemia of chronic disease
anaemia of renal failure

Question 10

what causes hypochromic microcytic anaemia

Answer 10

severe protein deficiency 
sideroblastic anaemia
thalassaemia
chronic inflammation 
iron deficiency

Question 11

what are the haematinic anaemias

Answer 11

iron
b12
folate

Question 12

what are the causes of macrocytic anaemia

Answer 12

• Alcohol		
• Pregnancy	
• Drugs	–	chemotherapy	(an*-folates,	an*-purines)	 															
															an*	HIV	drugs	
• Liver	disease	
• Raised	re*culocyte	count	
• Hypothyroidism	
• Myelodysplasia,	including	acquired	sideroblas*c anaemia
• Aplas*c	anemia	and	red	cell	aplasia	
• Hypoxia	
• Myeloma	and	other	paraproteinaemias

Question 13

what can cause warm autoimmune haemolytic anaemia

Answer 13

idiopathic
SLE
lymphoma
CLL
drugs
teratoma

Question 14

what can cause cold autoimmune haemolytic anaemia

Answer 14

ebv
mycoplasma pneumonia
UC

Question 15

what type of anaemia do you get in beta thalassaemia

Answer 15

microcytic

Question 16

how do you treat thalassaemia

Answer 16

blood transfusions
iron chelation
stem cell transplant

Question 17

what are the acute complications of sickle cells disease

Answer 17

painful crises
acute chest
stroke

Question 18

how can you classify haemolytic anaemias

Answer 18

Congenital:

• Membrane
• enzyme
• haemoglobin

aquired:

• autoimmune
• microangiopathic haemolytic anaemia
• drugs, infections, toxins
• copper

Question 19

what are the signs and symptoms of folate deficiency

Answer 19

sensory peripheral neuropathy

pre-conception- causes neural tube defects

Question 20

what are the symptoms of b12 deficiency

Answer 20

insidious onset
mild jaundice and anemia
glossitis
angular chelitis
neuropathy

Question 21

what can cause folate deficiency

Answer 21

nutritional 
intestinal
haemolysis
drugs
dialysis 
alcohol

Question 22

what is pernicious anaemia

Answer 22

when the immune system attacks healthy cells in your stomach preventing the body from absorbing b12

Question 23

why is important to check b12 levels before giving folate

Answer 23

Large amounts of folic acid can mask the damaging effects of vitamin B12 deficiency by correcting the megaloblastic anemia caused by vitamin B12 deficiency without correcting the neurological damage that also occurs

Question 24

what is von willebrand disease

Answer 24

missing clotting factor

Question 25

what type of anaemia do you get in kidney failure

Answer 25

normocytic

Question 26

why might a toddler have iron deficiency anaemia

Answer 26

too much cows milk