Anemia 1

Question 1

Investigating Anemia: 3 basic principles?

Answer 1

Where is the problem (primary bone marrow or peripheral)? Other cell counts? Consider patient - age, demographics, urgency of tests.

Question 2

Blood cells under normal conditions: life cycle and time line?

Answer 2

production in bone marrow, release into peripheral blood, senescence. RBC: 120 days, platelet: 7 - 10 days, neutrophil: 6-8 hours

Question 3

What causes blood cells to be low in number: 2 main pathological categories

Answer 3

Intrinsic bone marrow problem: inadequate blood cell production. Increased, loss, destruction or sequestration aka extrinsic/peripheral problems.

Question 4

If more cell lines are affected, then what is more likely?

Answer 4

Problem is with bone marrow production

Question 5

pancytopenia

Answer 5

deficiency of all three cellular components of blood: RBCs, WBCs and platelets, like in acute leukemia

Question 6

What 2 observations make it more likely that it is a primary bone marrow problem?

Answer 6

Pancytopenia. Abnormal immature cells in blood

Question 7

Anemia: definition? diagnosis?

Answer 7

a condition marked by a deficiency of red blood cells or of hemoglobin in the blood, resulting in pallor and weariness. NOT a diagnosis.

Question 8

Anemia: what concentrations of Hb?

Answer 8

<130 g/L males. <120 g/L females

Question 9

Anemia symptoms and signs depend on? (4)

Answer 9

Severity, rapidity of onset, age of patient, comorbid medical conditions

Question 10

Classification of anemia according to MCV

Answer 10

less than 80 microcytic. normal 80 - 100 fL. more than 100 is macrocytic.

Question 11

Causes of microcytic anemia (5)

Answer 11

TAILS: thalassemia trait, anemia of inflammation, iron deficiency, lead poisoning, sideroblastic anemia.

Question 12

Causes of macrocytic anemia (6)

Answer 12

FAT RBC: vitamin B12 or folate deficiency, high reticulocyte counts, liver disease, alcohol (drugs or toxins), myelodysplasia, hypothyroidism

Question 13

myelodysplasia

Answer 13

primary bone marrow problem characterized by ineffective blood cell synthesis: can involve one, two or all three cell lines

Question 14

General pathophysl of microcytic anemia: why small?

Answer 14

problem with Hb: too little Hb = smaller packaging with less content in each cell

Question 15

Iron def: pathophysl

Answer 15

not enough iron to make heme

Question 16

thalassaemia trait: pathophysls

Answer 16

not enough globin chains to make Hb

Question 17

anemia of inflammation: pathophysl

Answer 17

iron present, but not readily available for use