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Flashcards in Anaemia Deck (36)
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1

What is anaemia defined as?

Decrease in number of RBC, or decrease in oxygen-carrying capacity of blood cells

2

What are the mechanisms that can lead to anaemia?

- Decreased RBC production
- Increased RBC lysis
- Loss of blood

3

What is MCV?

Measurement of average volume of RBCs

4

What is a normal MCV?

80-100fl

5

What are the most common causes of microcytic anaemias?

- Iron deficiency anaemia
- Thalassaemia

6

What kind of anaemia is sideroblastic anaemia?

Generally microcytic, but may be normocytic

7

What are the causes of macrocytic anaemia?

B12 or folate deficiency.
Alcohol excess or liver disease.
Reticulocytosis eg with haemolysis
Cytotoxics, eg hydroxycarbamide.
Myelodysplastic syndromes.
Marrow infiltration.
Hypothyroidism.
Antifolate drugs (eg phenytoin).

8

What are the causes of normocytic anaemia?

Acute blood loss.
Anaemia of chronic disease (or ↓mcv).
Bone marrow failure.
Renal failure.
Hypothyroidism (or ↑mcv).
Haemolysis (or ↑mcv).
Pregnancy.

9

In general, how might patients with anaemia present?

- Fatigue
- Dyspnoea
- Headaches

10

What is iron deficiency anaemia?

Anaemia caused by inadequate iron intake, which leads to decreased RBC production

11

Who is at the highest risk of iron deficiency anaemia?

Pre-menopausal women (due to menstrual loss)

12

What is the most common cause of iron deficiency anaemia in men and post-meno women?

GI bleeding

13

What are the main mechanisms of development of iron deficiency anaemia?

- Insufficient dietary intake or malabsorption of iron
- Increased loss of iron
- Increased demand for iron

14

When might there be malabsorption of iron?

Coeliac disease

15

When might there be increased loss of iron?

- GI bleeding
- Cancer
- UC
- Endemic infectious diseases, e.g. hookwork, schisto

16

When might there be increased demand for iron?

During pregnancy

17

What is Plummer-Vinson syndrome?

Triad of;
- Iron deficiency anaemia
- Oesophageal webs
- Dysphagia

18

What does treatment of Plummer-Vinson syndrome involve?

- Iron replacement
- Endoscopic dilatation of oesophagus

19

Why is careful assessment required in Plummer-Vinson syndrome?

Patients at higher risk of developing oesophageal carcinomas

20

What initial investigations are done in iron deficiency anaemia?

- FBC
- Peripheral smear
- Iron studies

21

What will be found on peripheral smear in iron deficiency anaemia?

Hypochromic (central pallor of RBC), microcytic anaemia

22

What is found on iron studies in iron deficiency anaemia?

Low iron levels, but increased total iron binding capacity

23

What other investigations may be done in iron deficiency anaemia?

- Endoscopy
- Coeliac screen

24

When should patients with iron deficiency anaemia be referred for urgent 2 week wait endoscopy?

- Over 60
- Under 50 with rectal bleeding

25

When should coeliac screen be done in iron deficiency anaemia?

If indicated clinically

26

What is the first line management for iron deficiency anaemia?

Oral ferrous sulphate/fumurate

27

How long might it take for Hb to normalise with oral iron replacement?

2 months

28

What should be considered for patients who do not respond to oral iron with iron deficiency anaemia?

Consider for IV iron replacement

29

What is it important to warn patients taking iron supplementation of?

Side effects of treatment, including black stools, constipation, and nausea

30

What are the main forms of thalassaemia?

- Alpha
- Beta