Anaemia Flashcards
What are haematinics?
Nutrients required for RBC production
- Iron
- B12
- Folate
Discuss general investigation for anaemia
Peripheral blood: low Hb should be evaluated with MCV, MCP and WCC
Bone marrow: cellularity, type of erythropoiesis (normoblastic or megaloblastic), infiltration of the marrow by cancer cells, iron stores
What are the mechanisms by which anaemia occurs?
a) Decreased production e.g. aplastic aneamia, CKD, hypothyridism, B12 deficiency, iron deficiency, chrnoic inflammatory disease
b) Blood loss
c) Increased destruction through intravascular or extravascular haemolysis
Outline the intial assessment if anaemia is suspected
Acute bleeding: rapid haemodynamic stabilisation is required - up to 30% of total blood volume may be lost before clinical manifestations appear
Flat neck veins when supine indicates at least 30-40% of blood volume has been lost
First step involves the use of the FBC to determine the type of anameia that is present, the MCV and RCW are the most useful
What MCV is classified at microcytic anaemia?
<80fL
Discuss iron deficiecy anaemia
- Most common cause of anaemia in the world, affects 30% of the population
Other than iron deficiency, what can cause microcytic hypochromic anaemia?
Thalassaemia, anaemia of chronid disease, sideroblastic anaemia
What can cause iron malabsorption?
Achlorhydia: lack of acid in gastric secretions
Gastric surgery
Chronic bowel disease
Resection of the proximal small bowel
What is Runner’s anaemia?
Haemolytic anaemia due to repetetive impact of the foot on the ground
What is the average daily dietary intake of iron in the UK?
15-20mg, 10% of which is absorbed
Discuss the types of iron
Non haem iron: derived from cereals which are commonly fortified with iron, vegtables, beans and lentils
Not well absorbed in the body
Haem iron: derived from myoglobin or haemoglobin in red meat - better absorbed than non-haem iron
