Anemia

Question 1

Haemolysis

Answer 1

Reduced survival of red cells in circulation

Question 2

Haemolytic anemia

Answer 2

RBC destroyed faster than replaced

Question 3

Microcytic anemia

Answer 3

Iron deficiency
Anemia of chronic disease
Thalassaemia

Question 4

Blood test of microcytic anemia

Answer 4

Ferritin high in chronic, low in iron deficiency
Transferrin low in chronic, high in iron deficiency
RBC low in iron, high in thalassemia

Question 5

Normocytic anemia

Answer 5

Recent blood loss
Failure of RBC production - bone marrow fail
Pooling of RBC in spleen - hypersplenism

Question 6

Macrocytic anemia

Answer 6

Lack of vitamin B12 or folic acid - megaloblastic anemia

Hemolytic anemia - either due to hereditary spherocytosis, autoimmune haemolytic anemia, or G6PD deficiency

Question 7

Hereditary spherocytosis

Answer 7

Increased reticulocyte
Treat with folic acid or splenectomy
Unconjugated bilirubin
Conjugated if it can reach liver but not pass bile duct and gallbladder

Question 8

Autoimmune hemolytic anemia

Answer 8

Raised LDH, reticulocyte, unconjugated bilirubin

Question 9

G6PD deficiency

Answer 9

Heinz body
Oxidant damage
Avoid oxidant drugs, no broad beans, avoid napthalene

Question 10

Iron deficiency anemia

Answer 10

Koilonychia and glossitis angular stomatitis
Investigate blood in stool - faecal immunochemical test, colonoscopy
Low MCV

Question 11

Anemia of chronic disease

Answer 11

Treat underlying cause
Caused by infection
Pro inflammatory