Anaemia

Question 1

give two causes of microcytic anaemia

Answer 1

iron deficiency anaemia

haemoglobinopathy/thalassaemia

Question 2

how do you manage IDA

Answer 2

ferrous sulphate 200mg tds until FBC is normal + 3/12

Question 3

what happens in thalassaemia

Answer 3

people produce too little haemglobin

• not enough globin chains

Question 4

give two causes of a normoctyic anaemia

Answer 4

anaemia of chronic disease

bone marrow failure

Question 5

give some examples of chronic diseases that may cause anaemia of chronic disease

Answer 5

chron's
arthritis
osteomyelitis
TB
Cancer

Question 6

describe iron studies seen in anaemia of chronic disease

Answer 6

normal/high ferritin
low serum iron
low transferrin

Question 7

describe roughly how anaemia of chronic disease occurs

Answer 7

iron becomes stuck in stores
new red cells are hard to move
low transferrin
MCV starts to fall
over time transferrin starts to fall resulting in failure to mobilise iron

Question 8

what do you need to diagnsoe anaemia of chronic disease

Answer 8

1. chronic disease
2. inflammatory markers
3. low transferrin

Question 9

how do you manage anaemia of chronic disease

Answer 9

treat the cause!

do not prescribe iron or transfuse

Question 10

describe pancytopenia

Answer 10

failure of red blood cells

• anaemia
• thrombocytopenia
• leukopenia

Question 11

what blood abnormalities might you see in bone marrow failure

Answer 11

pancytopenia

Question 12

what type of anaemia do you see in anaemia of chronic disease

Answer 12

normocytic anaemia

Question 13

what type of anaemia do you see in IDA

Answer 13

microcytic anaemia

Question 14

what type of anaemia do you see in bone marrow failure

Answer 14

normocytic anaemia

Question 15

what type of anaemia do you see in thalassaemia

Answer 15

microcytic anaemia

Question 16

what can cause bone marrow failure

Answer 16

malignancy

drugs (chemo, other cytotoxics, antibiotics)

Question 17

give some causes of macrocytic anaemia

Answer 17

haematinic deficiency (B12/folate)

Haemolysis

(other: altered lipid content, liver disease, alcohol, drugs, hypothyroidism)

Question 18

what type of anaemia would you see in haemolysis

Answer 18

macrocytic

Question 19

what type of anaemia would you see in haematinic deficiency

Answer 19

macrocytic

Question 20

describe the process of B12 deficiency

Answer 20

when B12 enters the stomach it comes into contact with a protein called INTRINSIC FACTOR, from GASTRIC PARIETAL CELLS.

the INTRINSIC FACTOR allows it to be absorbed in the small bowel, particularly in the small bowel

Question 21

give some causes of B12 deficiency

Answer 21

vegans
pernicious anaemia
ileal disease

Question 22

what causes pernicious anaemia

Answer 22

lack of intrinsic factor from gastric parietal cells

50% have autoimmune antibodies to IF

Question 23

what roughly is haemolysis

Answer 23

shortened red cell survival

Question 24

what should you always check before replacing folate

Answer 24

that B12 is normal

Question 25

how do you manage B12 deficiency

Answer 25

give x6 loading injections over 2 weeks, then once every 3 months

Question 26

give some signs of haemolysis

Answer 26

jaundice dark urine signs of anaemia splenomegaly

Question 27

give some intrinsic causes of haemolytic anaemia

Answer 27

sickle cell disease thalassaemia G6PD deficiency

Question 28

give some extrinsic causes of haemolytic anaemia

Answer 28

``` EBV] typhoid E.coli leukaemia lymphoma tumours HELLP hepatitis SLE ```

Question 29

what tests should you do if you suspect haemolytic anaemia

Answer 29

blood film coomb's test get a haematologist!