Anaemia

Question 1

Define Anaemia

Answer 1

Reduced levels of haemoglobin

Question 2

How do you treat Iron-deficiency anaemia

Answer 2

Usually, oral iron
Blood Transfusion
In pregnancy, Oral Iron + folic acid

Question 3

Megaloblastic anaemia

Answer 3

Abnormal RBC maturation due to defective DNA synthesis, out of step with cytoplasmic development: bone marrow contains megaloblasts
Macrocytic

Question 4

What are the RBCs like in Megaloblastic Anaemia + why?

Answer 4

Macrocytic - RBCs are larger than normal volume
This is due to Vit.B12 / Folate deficiency
- Increased incidence in alcohol abuse

Question 5

Symptoms of Megaloblastic anaemia

Answer 5

Anaemia + Jaundice

Question 6

How is Jaundice caused in megaloblastic anaemia?

Answer 6

Excess breakdown of Hb due to increased ineffective erythropoiesis

Question 7

B12

Answer 7

Co-factor for purine + pyrimidine synthesis

Question 8

What is needed to absorb Vit.B12?

Answer 8

Intrinsic factor - secreted by stomach to help absorb B12

Question 9

When is intrinsic factor absent?

Answer 9

After Gastrectomy

Question 10

What is folic acid essential for?

Answer 10

Thymidylate synthesis

Question 11

When is folic acid used + where is it found?

Answer 11

In pregnancy + in most foods

Question 12

Function of Methotrexate + how to treat it?

Answer 12

Inhibits dihydrofolate reductase

Treat with Folinic acid

Question 13

What is Pernicious anaemia + how do you treat it?

Answer 13

Lack of intrinsic factor for B12 absorption due to autoimmune disease
Treat with Hydroxocobalamin IM

Question 14

Crohn’s disease

Answer 14

Malabsorption of Vit B12/ Folate or Iron

Question 15

Haemolytic Anaemia

Answer 15

Increased rate of RBC destruction

Question 16

What is Spherocytosis

Answer 16

Under Haemolytic anaemia
Genetic
Abnormal reduction in the RBC membrane protein Spectrin - make cells fragile

Question 17

How can you get Haemolytic anaemia?

Answer 17

Malaria
Haemolytic Transfusion reaction
Drug-induced

Question 18

What are the symptoms of haemolytic anaemia?

Answer 18

Jaundice + Enlarged spleen

Folate deficiency can occur due to increased erythropoiesis

Question 19

Sickle cell anaemia

Answer 19

Genetic - single nucleotide polymorphism (SNP)
Amino acid substitution - Convert Glutamic acid for Valine
Abnormal Hb - insoluble forms crystals at low O2 - RBC form sickle shapes and may block microcirculation.
Causes haemolytic anaemia

Question 20

Aplastic anaemia

Answer 20

Insufficient production of RBCs, WBCs and platelets (pancytopenia) - although may just be RBCs (pure red cell aplasia)

Question 21

What does aplastic anaemia cause?

Answer 21

Decreased resistance to infections, increased bleeding + tiredness

Question 22

How can you acquire aplastic anaemia?

Answer 22

Viral, radiation, drugs

Insecticides, sulphonamides, chloraphenicol + cytotoxic (anti-cancer drugs)

Question 23

How do you treat aplastic anaemia?

Answer 23

Bone marrow transplant (tissue match)
Immunosuppressant (prevent immune destruction of stem cells)
Colony - stimulating factor (increases WBC count)

Question 24

Thalassemia

Answer 24

Genetic
Reduced rate of alpha + beta globin unit production
= production of abnormal RBC

Question 25

Deletion of both alpha genes in Thalassemia leads to...

Answer 25

Death in uterus as Hb produced

Question 26

Deletion of ONE alpha gene in Thalassemia leads to...

Answer 26

reduction of RBC volume + haematocrit

Question 27

How do you determine anaemia?

Answer 27

Blood flow

Question 28

Glossitis

Answer 28

Painful red tongue

Question 29

Angular cheilitis

Answer 29

Fissures at corner of the mouth

Question 30

Symptoms for anaemia

Answer 30

Lethargy (lack of energy) Tachycardia (increased heart rate) Shortness of breath

Question 31

When Input is reduced, it is caused by...

Answer 31

Poor diet; removal of stomach

Question 32

What is Polycythaemia

Answer 32

Increased Hb content + haematocrit | -Increased blood viscosity = poor tissue perfusion

Question 33

Symptoms of Polycythaemia

Answer 33

Ruddy appearance Headaches Blurred vision Hypertension

Question 34

What causes the polycythaemia

Answer 34

Primary: bone marrow changes, stem cell defect Secondary: increased erythropoietin - altitude, smoking, renal carcinoma

Question 35

Primary treatment of Polycythaemia

Answer 35

Venesection, radioactive phosphorus, cytotoxic agents

Question 36

Macrocytic

Answer 36

Larger RBCs

Question 37

Microcytic

Answer 37

Smaller RBCs