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Anemia Flashcards

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1
Q

Name the 4 pathological processes involved in anemia of chronic disease

A
  1. Chronic infection
  2. Chronic inflammation
  3. Neoplasia
  4. Chronic kidney disease
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2
Q

Characterise anemia of chronic disease

A

Normocytic and normochromic

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3
Q

Name the protein used to transfer iron in the bloodstream

A

Transferrin

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4
Q

Characterise iron deficiency anemia

A

Microcytic hypochromic

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5
Q

What does normochromic mean

A

Concentration of haemoglobin in an average RBC is normal

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6
Q

What are the 2 subdivisions of macrocytic anemias?

A

Nonmegaloblastic and megaloblastic

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7
Q

Suggest 4 potential causes of non megaloblastic anemia

A
  1. Alcoholism
  2. Liver disease
  3. Hypothyroidism
  4. Myelodisplastic syndromes
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8
Q

What other 2 blood abnormalities often accompany a non megaloblastic macrocytic anemia in cases of myelodisplastic syndrome?

A
  1. Leukocytopenia

2. Thrombocytopenia

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9
Q

Suggest 5 medications that can cause a macrocytic anemia

A
  1. Drugs that affect DNA synthesis
  2. Trimethoprim
  3. Phenytoin, sodium valproate
  4. Metformin
  5. Antivirals e.g. Valacyclovir
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10
Q

Give 3 examples of drugs that affect DNA synthesis

A
  1. Azathioprine
  2. Cyclophosphamide
  3. Sulphasalazine
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11
Q

What is the most common cause of megaloblastic anemia?

A

Pernicious anemia

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12
Q

What are the 3 potential causes of vitamin B12 deficiency?

A
  1. Malabsorption (pernicious anemia or coeliac disease)
  2. Insufficient dietary intake
  3. HIV
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13
Q

Where in the digestive system is folate absorbed?

A

Passive diffusion in the jejunum

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14
Q

What is the function of vitamin B12?

A

Coenzyme that produces methionine from homocysteine. This then converts folic acid into its active form.

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15
Q

What are the 3 textbook physical signs of anemia?

A
  1. Pallor
  2. Bounding Pulse
  3. Systolic flow murmur
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16
Q

What are the ‘normal’ ranges for Hb in males and females respectively?

A

Male - 121-166 g/L

Female - 121-151 g/L

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17
Q

What is the ‘normal’ MCV range?

A

77-94 fl

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18
Q

What is the normal MCH range?

A

27-34 pg

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19
Q

What is a normal white cell count?

A

4.5-13.0 *10^9/L

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20
Q

What is a normal neutrophil count?

A

1.5-6.0*10^9/L

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21
Q

What is a normal lymphocyte count?

A

1.5-4.5*10^9/L

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22
Q

What is a normal platelet count?

A

150-400*10^9/L

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23
Q

What is a normal absolute reticulocyte count?

A

40-105*10^9/L

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24
Q

Women presenting with iron deficiency anemia as a result of menorrhagia should be routinely screened for what blood abnormality?

A

Von Willebrand’s disease

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25
Name a frequent complication associated with hereditary spherocytosis
Gallstones
26
What is the main cause of death for patients with beta thalassaemia major?
Cardiac iron overload
27
Name 3 side effects associated with EPO administration
1. Increased BP 2. Pure red cell aplasia 3. Thrombotic tendency
28
Name 2 conditions that pigmented gallstones can be associated with
1. Haemolytic anemia | 2. Liver cirrhosis
29
What are the 3 main causes of a normocytic, normochormic anemia?
1. Acute blood loss 2. Anemia of chronic disease 3. Anemia of renal failure (deficiency in EPO)
30
What is the pathophysiology of RBC production associated with sideroblastic anemia?
Slowing of porphyrin ring synthesis
31
What is the pathophysiology of RBC production associated with thalassaemia?
Reduction in the speed/quantity of globulin synthesis
32
Name the 3 haematinic deficiencies that may lead to anemia
1. Iron 2. B12 3. Folate
33
What type of anemia is associated with thalassaemia?
Hypochromic, microcytic anemia
34
What is beta thalassaemia minor and how can it be diagnosed?
Effectively a carrier of beta thalassaemia as these individuals only possess one abnormal beta globing gene. Can be diagnosed by having a raised HbA2.
35
Outline the 4 types of alpha thalassaemia with reference to the number of deleted genes.
I gene deleted - Clinically silent 2 genes deleted - alpha thalassaemia trait 3 genes deleted - Haemoglobin H disease 4 genes deleted - Bart's Hydrops Fetalis
36
Name 3 medical conditions in which patients often suffer from malabsorption of vitamin B12
1. Crohn's 2. Coeliac 3. Cystic fibrosis
37
How much elemental iron should be given to patients with iron deficiency anemia each day?
100-200 mg
38
What drug category can reduce the absorption of iron tablets if administered at the same time?
Tetracyclines
39
What is the name of the vitamin B12 injection given to patients?
Hydroxocobalamin injection
40
Define a haemolytic anemia
Anemia due to the destruction of red blood cells
41
Name 2 congenital causes of haemolytic anemia that affect the cell membrane of RBCs
1. Hereditary eliptocytosis | 2. Hereditary spherocytosis
42
Name 2 congenital causes of haemolytic anemia that are as a result of RBC enzyme deficiencies
1. G6PD | 2. Pyruvate kinase
43
Name 2 congenital causes of haemolytic anemia that are brought about by RBC haemoglobin disorders
1. Thalassaemia | 2. Sickle cell disease
44
Suggest 4 potential causes of acquired haemolytic anaemia
1. Autoimmune haemolysis 2. Microangiopathic haemolytic anemia 3. Drugs 4. Wilson's disease
45
Outline the 2 components of primary stroke prevention in patients with sickle cell disease
1. Detection using transcranial Doppler | 2. Start regular transfusions
46
What is IRIDA?
Iron refractory iron deficiency anemia - Autosomal recessive condition that will not respond to oral iron supplimentation
47
IRIDA is caused by mutations in which gene?
TMPRSS6
48
What are the 4 main causes of a hypochromic microcytic anemia?
1. Iron deficiency 2. Anemia of chronic disease 3. Sideroblastic anemia 4. Thalassaemia
49
Hyper-segmented neutrophils are seen on the blood film of patients with which type of anaemia
Megaloblastic anemias
50
What is the inheritance pattern of hereditary spherocytosis?
Autosomal Dominant
51
What is the characteristic feature of G6PD deficiency?
Episodic intravascular haemolysis
52
What is the inheritance pattern of G6PD deficiency?
X-linked
53
What is the inheritance pattern of pyruvate kinase deficiency?
Autosomal recessive
54
Recall the autoantibodies associated with warm and cold AIHA respectively
Warm - IgG | Cold - IgM
55
Suggest 4 potential causes of warm autoimmune haemolytic anemia
1. SLE 2. Lymphoma 3. Chronic lymphocytic leukaemia 4. Drugs e.g. methyldopa
56
What is the main pathophysiological difference between warm and cold AIHA?
The temperature at which maximal haemolysis occurs - hence warm or cold. In addition in warm AIHA, haemolysis occurs extravascularly e.g. the spleen where as in cold AIHA haemolysis coccus intravasculalry.
57
Suggest 3 potential causes of cold AIHA
1. Lymphoma 2. Mycoplasma infection 3. EBV infection
58
Outline 3 types of microangiopathic haemolysis
1. Thrombotic thrombocytopenic purpura 2. Haemolytic uremic syndrome 3. DIC
59
What is Coomb's test?
Antiglobulin test used to test the patients serum for antibodies to red blood cells
60
Name the 2 types of anti globulin tests performed as well as their indications
1. Indirect antiglobulin test - used to crosshatch for transfusion suitability 2. Direct antiglobulin test - Detection of antibodies to the patients own serum which can cause an autoimmune haemolytic anemia
61
What is the triad of symptoms associated with Plummer-Vinson syndrome?
1. Oesophageal webs 2. Iron deficiency anemia 3. Dysphagia
62
Define sideroblastic anemia
Abnormality of Haem production in the porphyrin pathway
63
Give 2 potential causes of acquired sideroblastic anemia
1. Lead poisoning | 2. Isoniazid

TCD Cases (25 decks)

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