Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

3 HAEM > ANAEMIA > Flashcards

ANAEMIA Flashcards

(79 cards)

Start Studying
1
Q

what is the definition of anaemia

A

reduced total red cell mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

which markers are used to assess for anaemia

A

haemoglobin concentration and haematocrit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the normal levels of Hb concentration and haematocrit for males and females

A 
males
Hb 130-180
Hct 0.38-0.55
females 
Hb 120-180
Hct 0.37-0.47
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how is Hb concentration measured

A 
burst red cells to create Hb solution 
stabilise the Hb molecules with cyanide
measure the optical density 
density is proportional to density 
concentration is calculated against a known standard solution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what does Beer’s law state

A

optical density is proportional to concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the haematocrit

A

ration of the whole blood that is red cells if the sample was left to settle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

in what situation might Hb/Hct not be an accurate marker

A

directly after an acute rapid bleed (falsely reassuring)

after harm-dilution with fluids (falsely worrying)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how do reticulocytes differ from mature RBCs

A

larger than average RBCs
still have remnants of protein making machinery (RNA)
stains purple/deeper red due to presence of RNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is a polychromatic blood film

A

shows different colours

presence of reticulocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the normal reactive response to anaemia

A

reticulocytosis

increased production of reticulocytes by the bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

measured red cell indices

A

Hb concentration
number of red cells
MCV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

calculated red cell indices

A

haematocrit
mean cell Hb
(mean cell Hb concentration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pathophysiological classifications of anaemia

A

decreased production (low reticulocyte count)

  • hypo proliferative
  • maturation abnormality

increased loss/destruction of red cells (high reticulocyte count)

  • bleeding
  • haemolysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what types of maturation abnormality can occur

A 
cytoplasmic defects (impaired haemoglobinisation)
nuclear defects (impaired cell division)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how can the MCV be used to distinguish maturation abnormalities

A

low MCV consider problems with haemoglobinisation (cytoplasmic)

high MCV consider problems with cell division (nuclear)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

define microcytic and macrocytic

A

microcytic = low MCV

macrocytic = high MCV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

microscopic features of microcytic anaemias

A

low Hb content
small cells
hypo chromic (lacking in colour)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the deficiency in hypo chromic, microcytic anaemia

A

deficient haemoglobin synthesis (cytoplasmic defect)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the commonest cause of microcytic anaemia

A

iron deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is thalassaemia and what type of anaemia is it

A

globin deficiency

hypochromic microcytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

causes of hypo chromic microcytic anaemia

A

haem deficiency

  • lack of iron
  • anaemia of chronic disease (lack of available iron)
  • problems with porphyrin synthesis

globin deficiency
- thalassaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is iron needed for

A

oxygen transport

electron transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the structure of Hb

A

four globin subunit
each globin contains one haem molecule
each haem molecule contains on Fe2+ ion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

which molecule transfers iron from liver stored to the erythroid

A

transferrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is the name of the molecule that iron is stored as
ferritin
26
where is the main iron store in the body
liver
27
how can ferritin be used to assess iron stores
it goes up when iron replete and down when iron deficient
28
how to assess iron status
``` Hb (functional iron) transported iron - serum iron - transferrin - transferrin saturation storage iron - serum ferritin ```
29
ow many binding sites are there in a molecule of transferrin
2
30
what does the % saturation of transferrin with iron measure
iron supply
31
in what situations might % saturation of transferrin with iron be abnormal
reduced in iron deficiency reduced in anaemia of chronic disease increased in genetic haemachromatosis
32
what does low serum ferritin mean
iron deficiency
33
causes of iron deficiency
not eating enough losing too much (bleeding) not absorbing enough
34
what is the difference between relative deficiency and absolute deficiency of iron
relative deficiency = still eating a normal amount but physiological increased demand eg child bearing age woman and children absolute deficiency = not eating a normal amount eg vegetarian diet
35
what is achlorhydria
deficiency of HCl resulting in impaired absorption of non-haem iron
36
common causes of chronic blood loss
menorrhagia GI tumours/ulcers haematuria
37
what is the equivalent iron loss due to menstrual bleeding per month
15-20 mg/month
38
what happens if there is an iron deficiency
exhaustion of iron stores iron deficient erythropoiesis (falling red cell MCV) microcytic anaemia epithelial changes (skin, koilonychia)
39
why is occult blood loss a risk factor for microcytic anaemia
a small volume of GI blood loss can occur without symptoms | this can outstrip the maximum dietary iron absorption of iron
40
signs of macrocytic anaemia on FBC
Hb low RBC low MCV high
41
how can you tell if RBCs are normocytic on a blood film
size of the nucleus of a normal small lymphocyte should correspond to the size of RBC
42
what are the causes of macrocytosis
genuine - megaloblastic - non-megaloblastic spurious
43
what are erythroblasts/normoblasts
normal red cell precursors with a nucleus
44
what are the steps of erythroblasts developing into RBCs
accumulate Hb reduce in size lose nucleus when Hb content optimal
45
at what point to red cell precursors stop dividing
late normoblast
46
what are the names of the cells as red cell precursors develop into mature red cells
``` pronormoblast early normoblast intermediate normoblast late normoblast reticulocyte RBC ```
47
define megaloblast
an abnormally large nucleated red cell precursor with an immature nucleus
48
how are megaloblastic anaemias characterised
predominant defects in DNA synthesis and nuclear maturation but RNA and HB synthesis are preserved
49
what is the result of megaloblastic development
reduced division | apoptosis
50
how does megaloblastic development result in anaemia
nuclear development is impaired but Hb accumulation is not once Hb level is optimal, the immature nucleus is removed leaving a bigger than normal cell the cells are bigger, but there are less of them because they were not able to divide ANAEMIA
51
causes of megaloblastic anaemia
``` B12 deficiency folate deficiency (drugs, congenital abnormalities) ```
52
why do we need B12 and folate for effective RBC development
essential co-factors for nuclear maturation | enable chemical reaction for DNA synthesis and gene activity
53
what is the folate cycle important for
nucleoside synthesis
54
what is the methionine cycle important for
producing a methyl donor (s-adenosyl methionine) to switch genes on/off
55
causes of B12 deficiency
diet (vegans) stomach (pernicious anaemia, atrophic gastritis, PPIs, gastrectomy) small bowel (bacterial overgrowth, coeliac, Crohn's, resection) inherited deficiencies of things
56
what is pernicious anaemia
autoimmune destruction of gastric parietal cells | results in intrinsic factor deficiency with B12 malabsorption and deficiency
57
anaemic patient with family history of autoimmune conditions??
pernicious anaemia
58
dietary sources of B12 and folate
B12 animal products folate liver, leafy veg, fortified cereals
59
how long do B12 stores last
2-4 years
60
how long do folate stores last
4 months
61
causes of folate deficiency
inadequate intake malabsorption excess utilisation (haemolysis, increased skin turnover, pregnancy, malignancy) drugs (anticonvulsants)
62
clinical features of B12 and folate deficiency
symptoms/signs of anaemia weight loss, diarrhoea, infertility sore tongue, jaundice developmental problems
63
in which system is B12 deficiency more likely to cause symptoms that folate
``` neurological system posterior/dorsal column abnormalities neuropathy dementia psychiatric manifestations ```
64
what is pancytopenia
all cells low | red and white and platelets
65
what is a macrovalocyte
macrocytic RBC that is oval shaped
66
hyperhsegmented neutrophils are a sign of what
B12/folate deficiency
67
how to assess for B12/folate deficiency
``` blood films (for macrovalocytes) B12/folate levels antibody tests (pernicious anaemia) ```
68
which autoantibodies are useful for investigation of pernicious anaemia
anti-intrinsic factor (specific, not sensitive) | anti-gastric parietal cell (sensitive, not specific)
69
treatment of megaloblastic anaemia
treat the cause where possible IM vitamin B12 injections folic acid tablets red cell transfusions if life threatening
70
causes of non-megaloblastic macrocytosis
alcohol liver disease hypothyroidism marrow failure red cell membrane changes
71
what is spurious macrocytosis
mature red cell volume is normal but the MCV is measured as high
72
causes of spurious macrocytosis
reticulocytosis - increase in reticulocytes which are bigger than mature red cells - the machine measures reticulocytes as RBCs so thinks the MCV is higher cold agglutinations - cold temperatures (25 degrees) makes RBCs clump together and be registered as a giant cell
73
why do patients with pernicious anaemia have jaundice
intramedullary haemolysis | big cells get stuck in the bone marrow and breakdown, forming bilirubin --> jaundice
74
investigations for anaemia
``` history/exam/clinical contet FBC retic count blood film ferritin/B12/folate bone marrow biopsy ```
75
what is reticulocyte count a marker of?
red cell production
76
causes of hypo proliferative anaemia
``` marrow failure hypo metabolic marrow infiltration (malignancy, fibrosis) renal impairment chronic disease ```
77
how does renal disease cause anaemia
kidneys can't sense hypoxia and/or release epo to induce red cell production
78
pathophysiology of anaemia of chronic disease
inflammation causes macrophages to produce IL-6 unregulated hepcidin hepcidin prevents iron release from tissue by degrading ferraportin
79
when is a retic count indicated
if there is evidence of haemolysis eg from history, polychromasia

3 HAEM (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions