B4 Anaemia

Question 1

What qualities of RBCs are looked at on microscope slides?

Answer 1

Shape
Size
Colour

Question 2

What does anaemia mean?

Answer 2

Lack of blood

Question 3

True or false? Lack of Hb can result in anaemia?

Answer 3

True

Question 4

What is the most precious blood group?

Answer 4

Type O

Question 5

What is the easiest blood group to replace?

Answer 5

AB+

Question 6

For blood types, what does the +/ - refer to?

Answer 6

Rhesus

Question 7

What would happen if the wrong blood group was administered to a patient?

Answer 7

Coagulation from antibodies attacking surface antigens.

Question 8

What is the oxyhaemoglobin dissociation curve?

Answer 8

The relationship between oxygen partial pressures and oxygen binding to haemoglobin

Question 9

What is P50?

Answer 9

A conventional measure of hemoglobin affinity for oxygen.

Question 10

What happens to the oxyhaemoglobin dissociation curve if P50 increases?

Answer 10

It shifts to the right

Question 11

What does an increase in temperature do to the oxyhaemoglobin dissociation curve?

Answer 11

It shifts to the right

Question 12

What does an increase in pH do to the oxyhaemoglobin dissociation curve?

Answer 12

It shifts to the left

Question 13

What is the Bohr effect?

Answer 13

Oxygen binding affinity is inversely related both to acidity and to the concentration of carbon dioxide.

Question 14

What is the Haldane effect?

Answer 14

Deoxygenation of the blood increases Hb’s ability to carry carbon dioxide.

Question 15

What does oxygenation of Hb mean for carbon dioxide binding?

Answer 15

Less carbon dioxide can bind to Hb

Question 16

Where can a ‘double Bohr Effect’ be seen?

Answer 16

Fetal Haemoglobin

Question 17

What is methaemoglobin?

Answer 17

Haemoglobin that is ferric (Fe3+ instead of Fe2+)

Question 18

What is the problem with methaemoglobin?

Answer 18

It doesn’t like to give up its oxygen

Question 19

What do patients with methaemoglobin present with?

Answer 19

Difficulty breathing

Question 20

What is carboxyhaemoglobin?

Answer 20

Haemoglobin that has a much higher affinity for carbon monoxide than it does oxygen

Question 21

How much higher is the affinity of Hb for carbon dioxide in carboxyhaemoglobin?

Answer 21

218 times

Question 22

What is the problem with carboxyhaemoglobin?

Answer 22

It’s nearly impossible to replace carbon monoxide with oxygen on haemoglobin once it has been bound

Question 23

Where is carboxyhaemoglobin especially a problem?

Answer 23

Gas stoves/ Kitchens

Question 24

What is the relationship between kidney disease and RBC production?

Answer 24

Kidneys produce EPO which is necessary for RBC production in bone marrow

Question 25

What are the reasons for anaemia?

Answer 25

```  Infiltration  Infection  Inflammation  Poor diet  Malabsorption- problems taking up the building blocks  Increased consumption- parasites  Hereditary ```

Question 26

What is the assumed cause of athlete's anaemia?

Answer 26

Iron deficiency

Question 27

What is the grading system for haemorrhaging?

Answer 27

I-IV

Question 28

What is desanguination?

Answer 28

State of decreased blood volume

Question 29

What is the main reason for desanguination?

Answer 29

Decrease in blood plasma

Question 30

What is exsanguination?

Answer 30

Severe loss of blood

Question 31

What is haemoptysis?

Answer 31

Coughing up blood

Question 32

What is hematemesis?

Answer 32

Vomiting blood

Question 33

Where does hematemesis usually occur?

Answer 33

From upper GI tract above suspensory muscle of duodenum

Question 34

What does 'sanguine' usually refer to?

Answer 34

Blood

Question 35

What is epistaxis?

Answer 35

A nose bleed

Question 36

What is haematochesia?

Answer 36

Pooping blood

Question 37

What is melaena?

Answer 37

Making dark, sticky foeces containing partially digested blood.

Question 38

What is the cause of melaena?

Answer 38

Internal bleeding/ swallowing blood

Question 39

What does menorrhagia usually refer to?

Answer 39

Periods

Question 40

What is haematuria?

Answer 40

Weeing blood

Question 41

Where is the mutation in sickle cell anaemia?

Answer 41

Beta chain

Question 42

What type of genetic disorder is thalassaemia?

Answer 42

Autosomal recessive

Question 43

What is occult bleeding?

Answer 43

Bleeding that isn't visible to the patient or physician

Question 44

What types of blood tests may be done for patients with suspected anaemia?

Answer 44

Ferritin Iron studies Total iron binding capacity

Question 45

What is the difference between iron deficiency anasemia and thalassaemia?

Answer 45

Iron deficiency anaemia is more hypochromic

Question 46

List some sources of iron?

Answer 46

``` Dark-green leafy vegetables Iron-fortified cereals Wholegrains Beans Nuts Meat Apricots Prunes Chickpeas Raisins Iron Tablets ```

Question 47

What stops iron being absorbed into the diet?

Answer 47

``` Iron being ferrous Tea and coffee Calcium Anatacids PPIs Phytic acid ```

Question 48

Where can you find dietary phytic acid?

Answer 48

Wholegrain cereals

Question 49

Aside from having larger RBCs what is another mark of megaloblastic anaemia?

Answer 49

Multinucleated neutrophil

Question 50

What are the common causes of macrocytic anaemia?

Answer 50

Deficiency of folate | Deficiency of B12

Question 51

How is vitamin B12 deficiency caused?

Answer 51

Malabsorption caused by pernicious anaemia

Question 52

How is folate deficiency usually caused?

Answer 52

Diet | Increased requirements in pregnancy

Question 53

Why are B12 and folate needed to produce DNA?

Answer 53

To produce THF

Question 54

How does B12 make THF?

Answer 54

Converts methyl THF into THF

Question 55

How does folate make THF?

Answer 55

Converts dUMP into dTMP | These are building blocks of THF

Question 56

What neurological condition can B12 deficiency cause?

Answer 56

Subacute degeneration of the spinal cord

Question 57

What class of drug is methotrexate?

Answer 57

D-MOD

Question 58

How does methotrexate work?

Answer 58

Blocks production of THF by inhibiting folate; slows down rapidly dividing drugs

Question 59

What do you need to give patients if you're giving them methotrexate?

Answer 59

Supplementary folate

Question 60

List some causes of B12 and folate deficiency?

Answer 60

``` Malnutrition and malabsorption Poverty Pregancy Drugs Pernicious Anaemia Gastrectomy Small bowel disease etc. ```

Question 61

What is pernicious anaemia?

Answer 61

Deficiency of gastric intrinsic factor (GIF)

Question 62

How is pernicious anaemia caused?

Answer 62

Autoantibodies produced against parietal cells and intrinsic factor

Question 63

What can you do to assess the type of anaemia a patient has?

Answer 63

``` Test: Blood pressure Respiratory rate Oximetry Blood gas Colour of blood Foecal occult Full blood count Blood film Bone marrow ```

Question 64

What does a blood film with lots of reticulocytes in it mean?

Answer 64

So many cells are being made in the bone marrow that they're being pushed out before fully maturing.