Flashcards in Anaemia Deck (33)
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1

Symptoms of anaemia

Lethargy
SOB
Palpitations
Headache
Koilonychia

2

Koilonychia

Spoon shaped nails

A sign of iron deficiency anaemia.

3

5 broad causes of anaemia

Bleeding

Deficiencies: Iron, B12, folic acid.

Haemolytic: Short RBC lifespan, increase in RBC destruction.

BM dysfunction

Poor O2 utilisation or carriage.

4

Daily requirement for iron

1-3 mg/day

5

Tests for iron

Serum iron

Total iron binding capacity

Serum transferrin

% Transferrin saturation

Serum ferritin

6

Total iron binding capacity (TIBC)

This is an alternative measure of serum transferrin.

When there is an increase in iron loss, TIBC increases.

7

Ferritin

Protein that stores intracellular iron.

8

% transferrin saturation

The ratio between iron and transferrin. Will detect iron loss of transferrin:iron ratio is very high.

9

Causes of iron deficiency

Bleeding: menorrhagia, occult GI malignancy, GI ulceration.

Coeliac disease

Crohn's disease

Pregnancy

10

Vitamin B12 requirement

1-3 mcg / day

11

Folic acid requirement

100 mcg/ day

12

Microcytic hypochromic anaemia

Anaemia that shows small red blood cells.

Causes:
Iron deficiency
Thalassaemia

13

Macrocytic anaemia

Anaemia characterised by large red blood cells.

Causes:
B12/ folate deficiency
Myelodysplasia.

14

MCV

Mean corpuscular volume-

Average volume of red blood cells.

Average-: 80-100 fL

15

Megaloblastic anaemia

Macrocytic anaemia due to Vit B12 or folate deficiency. MCV is too high.

Features:
There is sufficient iron and precursors for cell growth.

BUT there is insufficient supply of precursors for cell division.

16

B12 deficiency

Vitamin B12 is required for precursors in cell divisions.

Causes:
Pernicious anaemia- autoimmune disease that destroys parietal cells, leads to loss of intrinsic factor.

Post gastric/ Ileal surgery

Crohn's disease

Parasitic infection- fish tapeworm.

17

Folate deficiency

Causes megaloblastic anaemia.

Causes:
Dietary- lack of intake

Coeliac and Crohn's disease

Excess utilisation: chronic haemolysis and pregnancy.

Alcohol

Drugs: phenytoin, methotrexate.

18

Poor utilisation of iron in the body

Iron can become stuck in macrophages.

This prevents it from being mobilised to early erythroblasts.

19

Causes for impaired proliferation of erythroid progenitors

Poor response to erythropoietin.

Unavailable iron prevents erythrocyte development.

20

Sickle cell anaemia

Autosomal recessive genetic condition.

Point mutation in beta-globin gene- HbS, abnormal haemoglobin.

RBC have very short lifespan- 20 days, compared to 100-120.

Episodes of sick cell crisis

21

Management of sickle cell anaemia

Analgesics

Hydration

Exchange transfusion for blood cells

22

Thalassaemia

Inherited autosomal recessive genetic condition that alters Hb gene expression.

Features:
Large spleen, liver, heart.
Misshapen bones.
Microcytic, hypochromic cells.

Distributed similarly to incidence of malaria

23

Bone marrow infiltration

Bone marrow malignancy.

Leukaemia
Lymphoma
Myeloma

24

Management of chronic anaemia

If iron deficient- oral ferrous sulphate for 3 months

If folate deficient- oral forate for 3 months

If B12 deficient- B12 injections for 3 months

Kidney failure- EPO

25

Complications of long term transfusion

Iron overload- haemochromatosis

Creation of allo-antibodies: antibodies created to target blood group antigen on a person's red blood cell.

26

Hereditary spherocytosis

Genetic condition that causes dysfunctional membranes in RBCs.

Causes RBCs to be sphere shaped instead of biconcave.

This structure is more likely to lyse and cannot flex through small blood vessels.

These cells are broken down rapidly in the spleen due to abnormal proteins present- leads to splenomegaly and aplastic anaemia

27

Hereditary elliptocytosis

Genetic blood disorder of RBC membrane causing the shape to be 'elliptical'.

This makes individuals more susceptible to haemolytic anaemia.

28

Haemoglobin
- Structure
- Gene

Protein that transports O2 in the blood.

Structure: 4 globin chains in HbA
- 2 alpha
- 2 beta

Genes:
- 4 alpha genes
- 2 beta genes

29

Beta thalassemia

Genetic condition that affects the expression of beta-globin in haemoglobin.
- 2 genes code for beta-globin.

Inherited in a autosomal recessive fashion.

Thalassemia trait- single gene defect
Major= both globin genes defect

30

Beta-thalassemia blood film

Will show hypochromic, microcytic red blood cells