Anaemia and Blood Groups

Question 1

What is the major determining factor of whether a person needs a transfusion after an acute drop in Hb?

Answer 1

How long that person can maintain a compensatory increase in HR

Question 1

What are three causes of haemolysis that are external to the RBC?

Answer 1

Immune mediated

Mechanical

Infection

Question 1

If you’re rhesis negative will you have anti-D antibodies?

Answer 1

Not unless you’re exposed to D antigen

Question 2

On a molecular level, what differentiates someone who is blood group A from B from O?

Answer 2

The gene they possess determines whether A or B will be added to their H antigen, or neither added in the case of O.

Question 3

What is the most common enzymatic cause of haemolysis? What is seen on blood film?

Answer 3

G6PD deficiency

Blister/bite cells, spherocytes

Question 4

Macrocytic anaemia with decreased reticulocytes indicates what?

Answer 4

B12 or folate deficiency

Alcohol abuse

Cytotoxic agents

Question 5

How do you test for immune mediated haemolysis?

Answer 5

DAT (Coomb’s test)

Question 5

Thalassemia causes what type of anaemia?

Answer 5

Microcytic

Question 6

What are some signs of increased destruction of RBCs?

Answer 6

Jaundice

Decreased Haptoglobins

Increased LDH

Question 7

What are some major signs of anaemia?

Answer 7

Palor

Lethargy

Failure to thrive

Hypoxia

Ischaemia

Tachycardia

Question 8

What is MCHC?

Answer 8

The ratio of MCH to MCV giving the mean Hb per unit of volume of the RBC cell

Question 9

What is polychromasia? What does it indicate?

Answer 9

RBC has RNA therefore it has left the bone marrow prematurely

Question 10

B12 deficiency causes which type of anaemia?

Answer 10

Macrocytic

Question 11

In what scenario is rhesis status problematic?

Answer 11

When a negative mother has a positive child

Question 12

Which blood group is the most rare?

Answer 12

AB ~3%

Question 13

What happens if the wrong blood group is transfused?

Eg A blood group receiving B blood

Answer 13

Immediate catatrophic immune response that is generally fatal

(The recipients antibodies’ attacking the donated RBCs)

Question 14

Which blood groups are most common?

Answer 14

A and O = ~30-40% each

Question 16

What is dyserythropoiesis?

Answer 16

Dysfunctional RBCs

Question 16

What does a bone marrow trephine give you over a bone marrow aspirate?

Answer 16

Cellular architecture

Question 17

On which chromosome are the ABO genes located?

Answer 17

9

Question 18

What percentage of Australians are rhesis positive?

Answer 18

98%

Question 19

Macrocytic anaemia with increase reticulocytes is indicative of what?

Answer 19

Haemorrhage

Haemolysis

Response to Fe or B12 treatment

Question 20

What is MCV?

Answer 20

Mean corpuscle volume - mean volume of RBCs

Question 21

Liver disease causes which type of anaemia?

Answer 21

Macrocytic

Question 22

What is polycythaemia?

Answer 22

Too many RBCs

Question 23

What is a membrane cause of haemolysis? What is seen on blood film?

Answer 23

Hereditary spherocytosis Spherocytes

Question 24

What type of blood can O people receive?

Answer 24

Only O

Question 25

What type of blood can A people receive?

Answer 25

A or O

Question 27

What is the most common cause of microcytic anaemia?

Answer 27

Iron deficiency

Question 28

What are some signs of increase production of RBCs?

Answer 28

Reticulocytes Polychromasia

Question 29

What is MCH?

Answer 29

The mean amount of Hb per RBC

Question 30

What type of blood can AB people receive?

Answer 30

Anything

Question 32

What are some Hb causes of haemolysis? What is seen on blood film?

Answer 32

Thalassemias Sickle cell Unstable Hb Sickle cells

Question 33

What are hypochromic RBCs?

Answer 33

RBCs without enough Hb

Question 34

What rhesis status must be monitored in pregnant women?

Answer 34

Rhesis negative

Question 35

What are some mechanical causes of haemolysis?

Answer 35

Sepsis with disseminated intravascular coagulation Hardware implants HUS

Question 36

Which responses to steroid therapy, IgG or IgM mediated haemolysis?

Answer 36

IgG

Question 38

What are inotropes?

Answer 38

Drugs that modulate the force of heart contraction

Question 39

What is the pathogenesis of anaemia of chronic disease?

Answer 39

Cytokines produced in the chronically inflamed state; IL-1, IL-6 and TNF-alpha stimulate the liver to produce hepcidin (along with other protein, eg CRP) Hepcidin inhibits to use of iron from stores causing insufficient haemoglobin to be made.

Question 40

Folate deficiency causes which type of anaemia?

Answer 40

Macrocytic

Question 41

How does the CVS respond to an acute drop in Hb?

Answer 41

Increase HR

Question 42

How is anaemia measured?

Answer 42

Hb concentration

Question 43

What is the equation for tissue oxygen delivery?

Answer 43

CO x Hb x %Satn x 1.34

Question 44

How do you diagnosis Thalassemias?

Answer 44

Hb electrophoresis