General Anaemia Overview (Red Cells 2)

Question 1

What is anaemia?

Answer 1

When you’re haemoglobin is below normal for your age and sex

Question 2

What should your haemoglobin levels be as a male 12-70?

Answer 2

140-180

Question 3

What should your haemoglobin levels be for >70?

Answer 3

116-156

Question 4

What should your haemoglobin levels be for a female 12-70?

Answer 4

120-160

Question 5

What should your haemoglobin levels be for a female >70?

Answer 5

108-143

Question 6

Why have males got a higher haemoglobin count?

Answer 6

due to the presence of androgens

Question 7

What are the general features of anaemia?

Answer 7

Cause = reduced oxogen delivery to the tissues

• tiredness
• breathlessness
• ankle oedema
• dizziness
• chest pain

Question 8

what does jaundice signify?

Answer 8

that you’re breaking down haemoglobin too fast and theres too much UNCONJUGATED haemoglobin in your blood.

Question 9

What are signs of bleeding?

Answer 9

dyspepsia

peri rectal bleeding

Question 10

what are signs of malabsorption?

Answer 10

weight loss

diarrhoea

Question 11

What is MCV?

Answer 11

Mean cell volume (size)

82-100

Question 12

What is MCH?

Answer 12

Mean cell haemoglobin

MCH = 27-32

Question 13

what are the types of cells found in anaemia?

Answer 13

• Hypochromic, microcytic
• Normochromic, Normocytic
• Macrocytic

Question 14

What are examples of hypo chromic, microcytic anaemias?

Answer 14

Iron deficiency anaemia
Thalassaemia
Secondary anaemia

Question 15

What are examples of normochromic, normocytic anaemias?

Answer 15

Haemolytic anaemia
Hereditary spherocytosis
G6PD deficiency
Sickle cell disease
Auto-immune haemolytic anaemia
Severe infection
Secondary anaemia 
Hypoplasia
Marrow infiltration
Leukaemias
Haemorrhage

Question 16

What are examples of macrocytic anaemia?

Answer 16

B12 deficiency (usually pernicious anaemia)
Folate deficiency
Alcohol abuse
Drug-induced 
Congenital bone marrow failures

Question 16

What are examples of macrocytic anaemia?

Answer 16

B12 deficiency (usually pernicious anaemia)
Folate deficiency

Question 17

What is the total iron in the body?

Answer 17

4g

Question 18

How does the body obtain iron?

Answer 18

Most iron is recycled.

New iron is absorbed at the duodenum.

Question 19

Where is iron taken up?

Answer 19

At the duodenum.
Into the bone marrow - to make RBCs.
into the muscles - where its used.
Into the liver - where excess is taken to be stored.

Question 20

Which molecule binds to iron to transport it through the plasma?

Answer 20

Transferrin - binds to iron in the plasma as a transport molecule.

Question 21

Which molecule does iron bind to which allows it to cross the cell membrane?

Answer 21

Ferroprotein

Question 22

Which molecule does iron bind to which allows it to be stored?

Answer 22

Iron binds to ferritin and is stored in the liver.

Question 23

which molecule controls iron movement around the body?

Answer 23

Hepcidin - blocks ferroprotein from moving iron out of the cell membrane to be used.

Question 24

When is hepcidin made?

Answer 24

Hepcidin is made when theres enough iron in the bone marrow and muscles. When there snot enough iron, hepcidin is turned off.

Question 25

When is hepcidin also increased?

Answer 25

It is increased when theres enough iron in the body. AND during inflammation - this is why you can have anaemia (because your cells are not getting enough iron) - despite you having large enough iron stores.

Question 26

What is pancytopenia?

Answer 26

Low levels of ALL blood cell types: Red blood cells White blood cells Platelets

Question 27

When should you be wary of giving blood transfusions in someone with anaemia?

Answer 27

When it has been a chronic condition and the patient has become physiologically adapted to the anaemia. Because you could induce heart failure. So you should only give 1 unit of blood to begin.

Question 28

If someone is haemolysing what blood levels will be altered?

Answer 28

``` Low haptoglobin (as free haemoglobin will have increased and bound to it) High reticulocyte count ```

Question 29

What does a DAGT/DAT positive result mean?

Answer 29

There are antibodies on the surface of red blood cells = immune haemolysis.

Question 30

What is common about most people with sickle cell disease?

Answer 30

Their spleen doesn't function as they age (hyposplenic).

Question 31

What is a dangerous side effect of blood transfusion?

Answer 31

Iron deposition in the endocrine organs and the heart. | Treatment is chelation therapy.