Flashcards in Anaemia Deck (33)
Symptoms of anaemia
Spoon shaped nails
A sign of iron deficiency anaemia.
5 broad causes of anaemia
Deficiencies: Iron, B12, folic acid.
Haemolytic: Short RBC lifespan, increase in RBC destruction.
Poor O2 utilisation or carriage.
Daily requirement for iron
Tests for iron
Total iron binding capacity
% Transferrin saturation
Total iron binding capacity (TIBC)
This is an alternative measure of serum transferrin.
When there is an increase in iron loss, TIBC increases.
Protein that stores intracellular iron.
% transferrin saturation
The ratio between iron and transferrin. Will detect iron loss of transferrin:iron ratio is very high.
Causes of iron deficiency
Bleeding: menorrhagia, occult GI malignancy, GI ulceration.
Vitamin B12 requirement
1-3 mcg / day
Folic acid requirement
100 mcg/ day
Microcytic hypochromic anaemia
Anaemia that shows small red blood cells.
Anaemia characterised by large red blood cells.
B12/ folate deficiency
Mean corpuscular volume-
Average volume of red blood cells.
Average-: 80-100 fL
Macrocytic anaemia due to Vit B12 or folate deficiency. MCV is too high.
There is sufficient iron and precursors for cell growth.
BUT there is insufficient supply of precursors for cell division.
Vitamin B12 is required for precursors in cell divisions.
Pernicious anaemia- autoimmune disease that destroys parietal cells, leads to loss of intrinsic factor.
Post gastric/ Ileal surgery
Parasitic infection- fish tapeworm.
Causes megaloblastic anaemia.
Dietary- lack of intake
Coeliac and Crohn's disease
Excess utilisation: chronic haemolysis and pregnancy.
Drugs: phenytoin, methotrexate.
Poor utilisation of iron in the body
Iron can become stuck in macrophages.
This prevents it from being mobilised to early erythroblasts.
Causes for impaired proliferation of erythroid progenitors
Poor response to erythropoietin.
Unavailable iron prevents erythrocyte development.
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
Management of sickle cell anaemia
Exchange transfusion for blood cells
Inherited autosomal recessive genetic condition that alters Hb gene expression.
Large spleen, liver, heart.
Microcytic, hypochromic cells.
Distributed similarly to incidence of malaria
Bone marrow infiltration
Bone marrow malignancy.
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
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.
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
Genetic blood disorder of RBC membrane causing the shape to be 'elliptical'.
This makes individuals more susceptible to haemolytic anaemia.
Protein that transports O2 in the blood.
Structure: 4 globin chains in HbA
- 2 alpha
- 2 beta
- 4 alpha genes
- 2 beta genes
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