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HYMS Y4 > KEY ANAEMIA > Flashcards

KEY ANAEMIA Flashcards

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1
Q

Define anaemia.

A

Hb level 2 standard deviations below the normal range for age and sex.

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2
Q

Normal Hb range for men.

A

130-180.

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3
Q

Normal Hb range for women.

A

115-165.

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4
Q

5 causes of microcytic anaemia.

A 
IDA
Anaemia of chronic disease
Thalassemia
Sideroblastic anaemia
Lead poisoning
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5
Q

5 causes of normocytic anaemia.

A 
Haemorrhage
Haemolytic anaemias
Leukaemia
Pure red cell aplasia
Aplastic anaemia
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6
Q

6 causes of macrocytic anaemia.

A 
B12/ folate deficiency.
Pregnancy
Chronic alcohol misuse
Drug induced (methotrexate)
Hypothyroidism
Myelodysplastic syndromes
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7
Q

MCV for microcytic anaemia?

A

<80

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8
Q

MCV for normocytic anaemia?

A

80-100

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9
Q

MCV for macrocytic anaemia?

A

> 100

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10
Q

How are microcytic anaemias further classified?

A

Iron studies.

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11
Q

How are normocytic anaemias further classified?

A

Reticulocyte count.

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12
Q

How are macrocytic anaemias further classified?

A

Megaloblastic vs. non-megaloblastic.

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13
Q

What can a mixed iron + B12/folate deficiency cause?

A

A normocytic anaemia (look at RDW to detect).

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14
Q

Iron studies in iron deficiency anaemia?

A

Low serum iron
Low ferritin
High transferrin/ TIBC

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15
Q

Iron studies in anaemia of chronic disease?

A

Low/ normal serum iron
Low/ normal ferritin
Low transferrin/ TIBC

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16
Q

Test used to detect Thalassemia?

A

Mentzer index (MCV/RBC)

<13 = Thalassemia

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17
Q

Causes of normocytic anaemia with <2% reticulocytes.

A

<2% reticulocytes = hypoproliferative:

Leukaemias
Aplastic anaemia
Pure red cell aplasia

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18
Q

Causes of normocytic anaemia with >2% reticulocytes.

A

> 2% reticulocytes = hyper proliferative:

Haemolytic anaemias
Haemorrhage

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19
Q

What does megaloblastic mean?

A

Presence of megalocytes with hyperhsegmented neutrophils.

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20
Q

Causes of megaloblastic macrocytic anaemia.

A

B12 deficiency
Folate deficiency
Drug-induced (methotrexate)

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21
Q

Causes of non-megaloblastic microcytic anaemia.

A

Alcohol abuse
Hypothyroidism
Pregnancy
Myelodysplastic syndromes

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22
Q

Where is iron absorbed?

A

Duodenum

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23
Q

How does iron travel in the blood?

A

Bound to transferrin.

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24
Q

How is iron stored in the blood?

A

By ferritin.

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25
Iron studies in sideroblastic anaemia?
High iron High ferritin Low transferrin/ TIBC.
26
4 main categories of cause for iron deficiency anaemia.
Decreased intake Decreased absorption Increased loss Increased demand
27
Why is it common to get a macrocytic anaemia a couple of days after a GI bleed or traumatic bleed?
Because bone marrow responds by producing large numbers of reticulocytes.
28
Drugs which can cause macrocytic megaloblastic anaemia.
Methotrexate Azathioprine Trimethoprim Phenytoin
29
Why does B12 deficiency need to be corrected before folate deficiency?
Giving folate first can cause subacute degeneration of the cord.
30
Where is B12 absorbed?
Terminal ileum.
31
Where is Folate absorbed?
Jejunum
32
Food substances containing B12?
Meat and dairy.
33
Food substances containing folate?
Green, leafy vegetables
34
Beta thalassemia inheritance pattern?
Autosomal recessive.§
35
When does Beta Thalassemia present?
Childhood.
36
Blood film finding in sideroblastic anaemia?
Ringed sideroblasts (Iron-engorged peri-nuclear mitochondria in developing RBCs).
37
5 causes of B12 deficiency?
``` Pernicious anaemia IBD Gastric bypass/ gastrectomy Poor dietary intake Veganism ```
38
5 causes of folate deficiency?
``` Elderly Alcohol dependent Haemolysis Pregnancy Malabsorption Anti-folate drugs (methotrexate) ```
39
The only anaemia to cause neurological symptoms?
B12 deficiency
40
Neurological symptoms of B12 deficiency?
Confusion Drowsiness Poor concentration Poor memory
41
Patients with pernicious are at an increased risk of what?
Gastric cancer
42
Pathognomonic blood findings in pernicious anaemia?
Increased IgA antibodies against intrinsic factor/ parietal cells
43
2 categories of haemolytic anaemia?
INTRAVASCULAR: RBCs broken down in blood vessels. EXTRAVASCULAR: RBCs broken down in spleen (more common)
44
3 categories of congenital causes of haemolytic anaemia?
Membrane abnormalities Metabolic machinery abnormalities Haemoglobin molecule abnormalities
45
2 forms of acquired haemolytic anaemia?
Cold autoimmune haemolytic anaemia Warm autoimmune haemolytic anaemia.
46
Main cause of haemolytic anaemia caused by membrane abnormalities?
Hereditary spherocytosis.
47
Findings in hereditary spherocytosis?
Circular cells Low Hb Raised reticulocytes
48
Main cause of haemolytic anaemia resulting due to a metabolic machinery abnormality?
G6PD deficiency.
49
Inheritance pattern of G6PD deficiency?
X-linked recessive.
50
Pathognomonic blood film finding in G6PD deficiency?
Heinz bodies.
51
2 forms of haemolytic anaemia that affect the haemoglobin molecule?
SCD | Thalassemia
52
Difference between warm and cold AIHA?
Warm occurs at body temperature | Cold occurs in the peripheries at lower temperatures
53
3 conditions warm AIHA is associated with?
CLL Lymphoma SLE
54
Warm AIHA is mainly caused by which antibodies?
IgG.
55
3 conditions cold AIHA is associated with?
Mycoplasma pneumonia Infectious mononucleosis Lymphomas
56
Cold AIHA is mainly caused by which antibodies?
IgM
57
Non-immune causes of acquired haemolytic anaemia?
Mechanical trauma Infections Hypersplenism
58
Urinary finding in those with haemolytic anaemia?
Haemosiderinuria
59
Test for autoimmune haemolytic anaemia?
Direct Coombs test
60
How is acute chest syndrome in those with SCA diagnosed?
Fever or respiratory symptoms + presence of infiltrates on XR.
61
Most common cause of osteomyelitis in those with SCA?
Salmonella.
62
Classic triad of haemochromatosis?
DM Bronze skin Hepatomegaly
63
Management for haemochromatosis?
Venesection
64
Prophylaxis for what condition can trigger haemolytic anaemia in those with G6PD deficiency?
Malaria.
65
RBC transfusion cut off in anaemia?
<60
66
RBC transfusion cut off in those who are anaemic with an ACS?
<80

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