Biochemical Tests 2: Macrocytic Anaemia

Question 1

What is the main feature of macrocytic anaemia? (1)

Answer 1

High MCV.

Question 2

What does a raised MCV + reduced Hb suggest? (2)

Answer 2

Vitamin B12 or folate deficiency.

Question 3

Explain the effect of macrocytic anaemia. (1)

Answer 3

Affects all cells of the body and due to B12 malabsorption results to strophic gastritis and lack of intrinsic factor secretion.

Question 4

What are the common s/s of macrocytic anaemia? (6)

Answer 4

Fatigue
Weakness
Dyspnoea
Sore red tongue
Diarrhoea
Mild Jaundice

Question 5

Explain the management process of folate deficiency.

Answer 5

Oral folic acid 5mg OD.

Question 6

Explain the management process of B12 deficiency. (2)

Answer 6

Replenish stores with hydroxocobalamin (B12):
- 1mg IM alternate days for 2 weeks.
- Maintenance 1mg IM every 3 months for life.

Question 7

Which patients would you see macrocytic anaemia? (1)

Answer 7

Excessive alcohol intake.

Question 8

How would the blood results look like for patients with high alcohol intake? (3)

Answer 8

Hb + RBC = Normal
MCV = Raised

Question 9

What factors can cause an increase in Hb levels? (1)

Answer 9

Increased RBC production

Question 10

What factors can cause an increase in RBC levels? (2)

Answer 10

Fluid Depletion e.g. diarrhoea, burns, dehydration
Polycythaemia

Question 11

What factors can cause an increase in PCV levels? (2)

Answer 11

Polycythaemia
Dehydration

Question 12

What factors can cause an increase in MCV levels? (5)

Answer 12

Macrocytic Anaemia
Folate + B12 deficiency
Liver Disease
Alcohol

Question 13

What factors can cause an increase in MCH levels? (1)

Answer 13

Determined by MCV.

Question 14

What factors can cause a decrease in Hb levels? (3)

Answer 14

Haemorrhage
Iron Deficiency
Marrow Depression

Question 15

What factors can cause a decrease in RBC levels? (4)

Answer 15

Fluid Overload
Macrocytic Anaemia
Marrow Aplasia
Haemolytic Anaemia

Question 16

What factors can cause a decrease in PCV levels? (4)

Answer 16

Bleeding
Kidney Disease
Liver Cirrhosis
Bone Marrow Disorders

Question 17

What factors can cause a decrease in MCV levels? (2)

Answer 17

Microcytic Anaemia
Iron deficiency

Question 18

What factors can cause a decrease in MCH levels? (1)

Answer 18

Determined by MCV.

Question 19

Define Aplastic Anaemia. (1)

Answer 19

Bone marrow aplasia A.K.A. Pancytopenia

Question 20

Define haemolytic anaemia. (1)

Answer 20

Accelerated RBC destruction.

Question 21

What factors can cause acute haemorrhage which can lead to anaemia? (3)

Answer 21

Trauma
GI bleed
Surgery

Question 22

What chronic conditions can cause anaemia? (3)

Answer 22

Carcinoma
RA
Renal Failure

Question 23

What is the main function of neutrophils? (1)

Answer 23

Ingests and kills bacteria, fungi and damaged cells.

Question 24

What factor can cause an increase in neutrophils? (1)

Answer 24

A.K.A. Neutrophilia
Bacterial infections

Question 25

What factor can cause a decrease in neutrophils? (2)

Answer 25

A.K.A. Neutropenia Viral infections Acute leukaemia

Question 26

W. Is CRP? (3)

Answer 26

C-reactive protein: Protein made in the acute phase response. Made in the liver Rises within 6 hrs of an acute event.

Question 27

What is the main function of platelets? (2)

Answer 27

Causes mechanical plugging of haemorrhage and initiates coagulation.

Question 28

What factors causes a rise in platelets? (3)

Answer 28

Thrombocytosis: - Malignancy - Autoimmune Disease - Inflammation

Question 29

What factors causes a fall in platelets? (2)

Answer 29

Thrombocytopenia: - Drugs - Leukaemia

Question 30

What is ESR? (2)

Answer 30

Erythrocyte Sedimentation Rate: - Measures acute phase response. - Used for monitoring chronic inflammatory diseases.

Question 31

Explain what Hb, RCC, HCT, MCV and MCH all indicate. (2)

Answer 31

Used to determine if the patient has anaemia. There are 2 types: Macrocytic (large RBC) /Microcytic (small RBC) Anaemia.

Question 32

Explain what platelets indicate. (1)

Answer 32

Involved with clotting.

Question 33

Explain what WCC, Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils all indicate. (2)

Answer 33

WBC count is important in monitoring drugs which cause bone marrow suppression. Also important in patients suffering from an infection.

Question 34

Explain what ESR indicates. (1)

Answer 34

Non-specific marker of inflammation.