Anaemia and microcytic anaemia

Question 1

Define anaemia

Answer 1

reduced total red cell mass

Question 2

what are surrogate markers used to measure red cell mass

Answer 2

haemoglobin Hb

haematocrit Hct

Question 3

For a male, at what levels are you anaemic

Answer 3

Hb < 130

Hct 0.38-0.52

Question 4

For a female, at what levels are you anaemic

Answer 4

Hb < 120

Hct 0.37-0.47

Question 5

Where does erythropoeisis occur

Answer 5

bone marrow

Question 6

what is a macrophage also known as

Answer 6

histiocyte

Question 7

how is Hb concentration measured

Answer 7

spectophotometric method

burst RBC to create Hb solution and measure optical density

Question 8

how do you measure haematocrit

Answer 8

ratio/% of the whole blood fluid that is red if it was left to settle

Question 9

are Hb and Hct always reliable markers of anaemia

Answer 9

no

Question 10

what is the response to anaemia

Answer 10

reticulocytosis

sign of increased red cell production

Question 11

what are reticulocytes

Answer 11

immediate precursors of red cells that have just left the bone marrow and entered the bloodstream

Question 12

features of reticulocytes

Answer 12

no nucleus - RNA is present
larger than RBC
purple colour
polychromatic blood film

Question 13

in terms of red cell parameters, what is measured and what is calculated

Answer 13

measured: Hb concentration, number and size of RBCs
calculated: Hct, mean cell Hb, mean cell Hb concentration

Question 14

in anaemia:

decreased production will have a high/low reticulocyte count

Answer 14

low - since bone marrow is not working effectively

Question 15

in anaemia:

increased destruction and loss of cells will have a high/low reticulocyte count

Answer 15

high - since marrow is working to compensate for loss

Question 16

what are causes of a low reticulocyte count

Answer 16

hypoproliferative - decreased erythropoeisis

maturation abnormality - cytoplasmic or nuclear

Question 17

what defect occurs if there is a cytoplasmic maturation abnormality

Answer 17

impaired haemoglobinisation

Question 18

what defect occurs if there is a nuclear maturation abnormality

Answer 18

impaired cell division

Question 19

what is MCV

Answer 19

mean cellular volume

Question 20

what is MCV useful for

Answer 20

distinguishing between cytoplasmic and nuclear defects

Question 21

what does a low MCV indicate

Answer 21

microcytic cells

cytoplasmic defect in haemoglobinisation

Question 22

what does a high MCV indicate

Answer 22

macrocytic cells

nuclear defect in maturation

Question 23

in which part of the cell is Hb synthesised

Answer 23

cytoplasm

Question 24

what makes up Hb

Answer 24

Haem = Fe2+ and Porphyrin

Globin

Question 25

deficiency of what causes small cells with low Hb content

Answer 25

low Fe, porphyrin, globin

Question 26

what do microcytic hypochromic cells indicate

Answer 26

deficient Hb synthesis from cytoplasmic defect

Question 27

what are causes of haem deficiency

Answer 27

iron deficiency anaemia of chronic disease abnormal porphyrin synthesis congenital sideroblastic anaemia

Question 28

what are causes of globin deficiency

Answer 28

thalassaemia

Question 29

how can iron exist in the body

Answer 29

Fe2+ --> ferrous state | Fe3+ --> ferric state

Question 30

what are the functions of iron

Answer 30

carry O2 in Hb and myoglobin transport electrons in mitochondria generate free radicals (dangerous)

Question 31

In iron studies: what tests for functional iron

Answer 31

Hb levels

Question 32

in iron studies: what tests for transported iron

Answer 32

serum iron transferrin transferrin saturation

Question 33

in iron studies: what tests for storage iron

Answer 33

serum ferritin

Question 34

what is transferrin

Answer 34

protein with 2 binding sites for iron atoms which transfers iron from donor tissue to cells expressing transferring receptors

Question 35

what is % transferrin saturation with iron

Answer 35

measurement of iron supply

Question 36

Iron deficiency and anaemia of chronic disease cause high/low %transferrin saturation

Answer 36

low

Question 37

haemochromatosis causes high/low %transferrin saturation

Answer 37

high

Question 38

what is ferritin

Answer 38

large intracellular storage protein that stores Fe3+

Question 39

what happens to ferritin if there is an increase in iron levels

Answer 39

ferritin levels go up

Question 40

low ferritin means there is iron deficiency, true or false

Answer 40

true

Question 41

what is an indirect measure of storage iron

Answer 41

serum ferritin

Question 42

what are causes of iron deficiency

Answer 42

insufficient dietary intake haemorrhage - menorrhagia, GI, haematuria malabsorption - coeliac, crohns

Question 43

where is iron absorbed in the GI tract

Answer 43

proximal gut

Question 44

what is needed to help iron absorption

Answer 44

acid