Anaemia Flashcards
(37 cards)
What is anaemia?
It is a marked decrease in haemoglobin or haematocrit below the normal values for the specific age and sex
What is severe anaemia?
<5g/dl
What is anaemia in children between 6 months and 5 years?
<11g/dl
What is anaemia in children between 12-15 years?
<12g/dl
What is the Hb value in a term baby and a preterm baby at birth?
- Term baby <13.5g/dl
2. Preterm <11g/dl
What are the causes of anaemia in the newborn?
- Impaired production
- infections(TORCH)
- HIV - Blood loss
- twin twin
- cord
- feta maternal - Haemolysis
- Rh/ABO incompatibility
- spherocytosis
- G6PD deficiency
What are the causes of anaemia in infants and pre-school children?
- Impaired production
- infection
- iron deficiency
- folate deficiency - Blood loss
- platelet/coagulation abnormalities - Haemolysis
- malaria
- spherocytosis
- G6PD deficiency
What are the causes of anaemia in older children?
- Impaired production
- iron deficiency
- folate deficiency
- acute leaukemia - Blood loss
- platelet, coagulation abnormalities - Haemolysis
- malaria
- spherocytosis
- G6PD deficiency
- thalassemia
When a child presents with pallor or shock, what cause should we think of?
Blood loss
When a child presents with jaundice or hepatosplenomegaly what should we think of?
Haemolysis
What helps us differentiate the cause of anaemia between blood loss, haemolytic anaemia and hypoplastic(anaemia due to impaired production of RBC?)
The reticulocytes count
What is the development of erythrocytes(RBC)
- Heamatopoetic stem cell becomes either WBC, RBC or platelets
- On the path to become a red blood cell it is a erythroblast then reticulocyte then erythrocyte
What does a reticulocyte count of >5% mean on blood smear?
That the anaemia is caused by haemolysis or blood loss because the bone marrow is working extra hard to compensate for the destruction of the red blood cells
What does MCV mean?
Mean corpuscular volume(basically the sizes of the cell)
What is anaemia caused by impaired function(underproduction) divided into?
- Microcytic <70 fl
- Normocytic (70-90 fl)
- Macrocytic (>90 fl)
What are the causes of microcytic anaemia and why?
- Thalassemia
- Iron deficiency anaemia
- Anaemia of chronic disease
- Sideroblastic anaemia
This anaemia occurs as a result of decreased production of haemoglobin in some way
-this then leads to the cell becoming progressively smaller
What are the causes of macrocytic anaemia?
> 90 fl
- usually due to problems with DNA synthesis(basically does not become smaller)
1. Liver disease
2. Megaloblastic anaemia-vitamin b12 deficiency, folate deficiency
2. Physiological-newborn
What is iron deficiency anaemia?
The most common cause of anaemia in children
-usually caused by not enough consumption of iron for the first 3 months of life
What age is the greatest risk of developing iron deficiency anaemia?
6 months to 3 years
What are the clinical signs of anaemia we can expect to see in children?
- Tiredness and lethargy
- Tachycardia and mild ejection systolic murmur
- Irritability and poor feeding
- Pallor and koilonychia
What type of anaemia is iron deficiency anaemia?
-it is a microcytic anaemia
What is the management for iron deficiency anaemia?
- Give oral ferrous supplements of 6mg/kg/day will correct in 90% of patients
- We would only consider blood transfusion when <4g/dl and with cardio/pulmonary symptoms or an infection
What is anaemia of chronic disease?
Chronic conditions that cause low grade anaemia due to malignancy, endocrine, hepatic disorder or infection because they cause cytokines to be released which release hepcidin in that prevents iron production
What are the megaloblastic anaemia?
Folate deficiency
Vitamin B12 deficiency
