BL4 Anaemia

Question 1

What is the result of reduction in the blood’s ability to oxygenate blood?

Answer 1

tissue hypoxia

Question 2

1) What is the mean male normal Hb?

2) What is bellow normal Hb for males?

Answer 2

1) 15.5g/dl

2) 13.5 g/dl

Question 3

1) What is the mean female normal Hb?

2) What is bellow normal Hb for females?

Answer 3

1) 14.0g/dl

2) 11.5 g/dl

Question 4

What does this symbol stand for g/dl?

Answer 4

Grams Per Decilitre

Question 5

What are the 2 possible cause of anemia to do with quantity?

Answer 5

May be due to insufficient HB and/or insufficient RBC

Question 6

1) Is anemia a disease?

2) What should you do when you identify a patient as anaemic?

Answer 6

1) no, it is a clinical sign

2) work out the cause

Question 7

What does the following stand for:

1) MCV
2) MCH
3) MCHC

Answer 7

1) Mean corpuscular volume
2) Mean corpuscular haemoglobin content
3) Mean corpuscular (cell) haemoglobin concentration

Question 8

What are the unit for these:

1) Mean corpuscular volume
2) Mean corpuscular haemoglobin content
3) Mean corpuscular (cell) haemoglobin concentration

Answer 8

1) (fl, femto = 10-15)
2) (pg, pico = 10-12)
3) (g/L or g/100 ml)

Question 9

What are the clinical manifestations of anaemia?

general and cardiorespiratory

Answer 9

General:
1) Headache
2) fatigue/lethargy
Cardiorespiratory:
3) Dyspnoea (difficult or laboured breathing)
4) Tachycardia (fast HR))
5) Palpitations (heart pounding/ fluttering)
6) Angina
7) myocardial infarction (heart attack)

Question 10

What are the clinical manifestations of anaemia?

cutaneous

Answer 10

Cutaneous:

1) pallor
2) brittle nails
3) koilonychias (abnormally thin nails (usually of the hand) which have lost their convexity, becoming flat or even concave in shape.)

Question 11

What are the clinical manifestations of anaemia?

oral

Answer 11

1) Sore Mouth
2) Glossitis (inflammation of the tongue)
3) Ulceration
4) Candidiasis (fungal infection in mouth)
5) Angular stomatitis ( inflammatory condition affecting the corners of the mouth or oral commissures)

Question 12

what are the 3 classificaiton of RBC based on size?

Answer 12

1) microcytic
2) normocytic
3) macrocytic

Question 13

1) What will you look for to confirm microcytic RBC?
2) What is the possible causes?
3) What tests will be used here?

Answer 13

1) hupochromic, low MCV and MCH
2) Fe deficiency
3) blood film and heamatocrit (for blood count)

Question 14

1) What will you look for to confirm normocytic RBC?
2) What is the possible causes?
3) What tests will be used here?

Answer 14

1) normochromic, normal MCH and MCH
2) Acute blood loss
Haemolysis
Marrow disease
3) blood film and heamatocrit (for blood count)

Question 15

1) What will you look for to confirm macrocytic RBC?
2) What is the cause?
3) What tests will be used here?

Answer 15

1) high MCV
2) B12 deficiency
Folate deficiency
(not infrequently
in alcoholics)
3) blood film and heamatocrit (for blood count)

Question 16

What are the 3 classifications of anaemia?

Answer 16

1) excess loss
2) failure of production
3) excess destruction

Question 17

How would excess loss of RBC lead to anaemia?

Answer 17

Acute haemorrhage
Chronic haemorrhage
(Fe deficiency
anaemia)

Question 18

How would failure of production of RBC lead to anaemia?

Answer 18

Deficiency anaemia (Fe,
B12, Folate)
Marrow disease e.g.
Aplastic anaemia,
Leukaemia

Question 19

How would excess destruction of RBC lead to anaemia?

Answer 19

Haemolytic anaemia:
Sickle cell anaemia,
Thalassaemia

Question 20

What happens during an acute haemorrhage?

Answer 20

body loses over 1 litre of blood, tissue fluid replaces loss= low RBC count, reticulocytes will be reactive

Question 21

1) What does chronic haemorrhage present as?

2) What can cause a chronic haemorrhage?

Answer 21

1) Fe deficiency ( 1ml blood loss contains 0.5mg of Fe)

2) Gastrointestinal blood loss

Question 22

What are the different causes of Gastrointestinal blood loss?

Answer 22

1) NSAID, a drug that can cause damage to the gastroduodenal mucosa via several mechanisms, including the topical irritant effect of these drugs on the epithelium,
2) stomach ulcers
3) stomach cancer- detected by looking at an endoscopy

Question 23

What causes failure of production of RBC a type of deficiency anaemia:

Answer 23

a deficiency in:

1) Iron
2) B12
3) Folate

Question 24

1) How much iron is in the body?
2) What are is the percentage of the total body iron is in each location:
a) Haemoglobin in RBC
b) Ferritin in liver macrophages
c) Myoglobin in skeletal muscle
d) transferrin in plasma

Answer 24

1) 3-5 g
2) a) 75%
b) 20%
c) 5%
d) 0.1 %

Question 25

WHat are the 4 locations of iron in the body?

Answer 25

a) Haemoglobin in RBC b) Ferritin in liver macrophages c) Myoglobin in skeletal muscle d) transferrin in plasma

Question 26

What is the daily requirement of iron for the following groups of people: 1) males 2) females 3) pregant lady 4) children

Answer 26

1) 1 mg/day 2) 2 mg/day 3) 3 mg/day 4) 1.5 mg/day

Question 27

How is iron mostly lost?

Answer 27

sloughing of epithelial cells | from skin and mucosal surfaces

Question 28

What is the daily loss of iron for males and females of blood?

Answer 28

Males 0.6 mg/day | Females 1.2 mg/day (incl. average menstruation loss

Question 29

What regulates the amount of iron?

Answer 29

by the control of iron absorption (10% from diet)

Question 30

1) How much iron is absorbed a day? | 2) How much iron do we consume a day?

Answer 30

1 mg/day | 2) 15-20mg per day

Question 31

What are the 2 types of sources of iron, where they come from and how easily they are absorbed + percentage:

Answer 31

1) non haem- from plant food, not easily absorbed (1-10%) | 2) haem- from myoglobin and Hb in meat - rapidly absorbed (10-20%)

Question 32

WHat are the inhibitors of iron absorbtion?

Answer 32

phytates, phosphates, tannins

Question 33

What are the promoter of iron absorbtion?

Answer 33

: Vit C, citric acid, alcohol

Question 34

1) What are the 2 stable valency states of iron? and which food type they come from? 2) WHich one is absorbed (a) and isn't (b)? (c) Why is this particularly bad? 3) Explain why stomach acid, vitamin C and alcohol promote iron absorption?

Answer 34

1) Fe++ (ferrous - in haem) and Fe+++ (ferric in non haem) 2) a) ferrous form b) ferric c) most dietary iron is in the ferric form 3) they are reducing agents and therefore reduce ferric iron into ferrous iron which cna be absorbed.

Question 35

What is malabsorption syndrome?

Answer 35

refers to a number of disorders in which the small intestine can't absorb enough of certain nutrients and fluids

Question 36

What can cause malabsorption?

Answer 36

1) high phytate diet-the phytate binds to some nutrients preventing their absorbtion 2) low vitamin C 3) Surgery- partial or total gastrectomy

Question 37

If a patient suffers from malabsobtion they will be given supplements. 1) what is the supplement? 2) What is the side effect of this supplement? 3) therefore what is subscribed instead? what are the benefits of this? 4) What can cause tooth erosion?

Answer 37

1) ferrous sulphate (200 mg 3x daily) 3 mo. or more 2) staining of teeth 3) iron edetate -sugar free and more palatable 4) some iron preparations and chewable Vitamin C tablets