Anaemia Flashcards Preview

HAEMATOLOGY > Anaemia > Flashcards

Flashcards in Anaemia Deck (50)
Loading flashcards...
1

What is the definition of anaemia?

Reduced total red cell mass (not easy to measure so Hb concentration is used as a surrogate marker)

Reduction in Hb concentration below that which is optimum for that patient or below 95% of the average range for the population

2

What are the two most common causes of anaemia worldwide?

Iron deficiency anaemia

Anaemia of chronic disease

3

Below what Hb concentration is anaemia likely to present in adult males and adult females?

Adult males <130g/l
Adult females <120 g/l

4

Below what Hb concentration is anaemia likely to present in pregnancy?

<110 g/l

5

What are reticulocytes?

Red cells that have just left the bone marrow - they are immature and larger than normal red blood cells. They still have remnants of RNA.

6

What colour do reticulocytes stain?

Reticulocytes stain purple/ deep red because they still have remnants of RNA

7

When is reticulocyte count increased?

In anaemic patients whose bone marrow is functioning normally

There is increased loss or destruction of cells


E.g haemolysis and blood loss

8

When is reticulocyte count decreased?

In patients with anaemia involving hypoproliferation or abnormal maturation

9

Different investigations can be done to investigate for; functional, storage and transport iron. What investigations are these?

Functional iron
- Hb concentration

Storage iron
- Serum ferritin

Transport iron
- Serum transferrin

10

What investigations can be done for anaemia?

Investigations for iron
(Hb concentration, serum ferritin, serum transferrin)

Reticulocyte count
(to assess marrow response)

Haematinics - folate and vitamin B12

MCV

Faecal occult blood testing

GI investigations

11

What is the problem in microcytic anaemia?

Defects in haemoglobin synthesis = cytoplasmic defect

(haemoglobin synthesis occurs in the cytoplasm)

12

What is the problem in macrocytic anaemia?

Defects in DNA synthesis

Cell division is reduced and apoptosis occurs. This means that the cells will be larger (because they do not divide because of the abnormal nucleus) but there will be less of them (since they undergo apoptosis) which is what causes the anaemia.

13

What two things are needed to make haemoglobin?

Porphyrin ring and iron(Fe2+)

*Shortages in these result in microcytic anaemia

14

What are the causes of hypochromic microcytic anaemia?

Haem deficiencies
- Iron deficiency
- Chronic disease
- Lead poisoning
- Pyridoxine responsive anaemias
- Congenital sideroblastic anaemia

Globin deficiency
- Thalassaemia

15

Problems with porphyrin synthesis can rarely cause microcytic anaemia. What are possible causes of this?

Lead poisoning

Pyridoxine responsive anaemias

16

What is circulating iron bound to and what is it stored as?

Circulating iron is bound to transferrin

Iron is stored in ferritin mainly in the liver

17

What are some of the possible causes of iron deficiency?

Low consumption

Malabsorption

Blood loss

18

Why might achlorhydria result in anaemia?

Acid is needed for the absorption of iron

19

Where is iron absorbed from in the GI tract?

Iron is absorbed from the jejunum (proximal bowel)

20

How is iron deficiency anaemia managed?

Ferrous iron (Fe2+) supplements

Vitamin C
(helps with the absorption of iron)

Management of the cause

21

What increase in reticulocytes would you expect per week when a patient is being treated for iron deficiency anaemia?

10g/L/week

Low reticulocytes might suggest poor compliance with iron supplements

22

How should a patient be managed if they are not compliant with iron supplements?

Try a lower dose and consider adding a laxative for GI symptoms

Can consider IV iron if necessary

23

What are some of the possible causes of normochromic normocytic anaemia?

Chronic diseases

Renal failure

Hypometabolic states e.g hypothyroidism

Marrow failure

24

What is the problem in microcytic anaemia?

There are defects in DNA synthesis

Cell division is reduced and apoptosis occurs, this means that the cells will be larger (because they don't divide) but there will be less of them (since they undergo apoptosis).

25

What would be the expected lab findings in macrocytic anaemia?

Low RBCs and Hb

High MCV

26

What units are used for macrocytosis and what is the cut off?

MCV stands for mean corpuscular (cellular) volume

>100 fl (femtolitres) is macrocytic

27

What is a megaloblast?

An abnormally large nucleated red cell precursor with an immature nucleus

28

What is an erythroblast?

A normal red cell precursor with a nucleus

29

What are the causes of megaloblastic macrocytic anaemia?

B12 or folate deficiency

Drugs

Inherited abnormalities

30

Where is B12 absorbed fro in the GI tract?

B12 is absorbed from the distal small bowel (ileum)