L26: Anaemia Flashcards
(34 cards)
Anaemia is a condition in which a patient has decreased haemoglobin.
What is the numerical value in:
a) Females
b) Males
a) Females < 11.5 g/dL
b) Males < 13 g/dL
What does hypochromic mean? (in regards to anaemia)
less Hb present in the RBCs
List some of the possible causes of anaemia
- failure to make RBCs
- lack of haematinics
- – from diet
- – autoimmune
- – malabsorption
- increased loss of RBCs
- reduced bone marrow function
- increased haemolysis
Where is intravascular and extravascular haemolysis done?
Intravascular = in peripheral blood
Extravascular = in spleen
Where in the GIT is iron absorbed?
stomach + duodenum
Where in the GIT is folate absorbed?
duodenum + upper jejunum
Where in the GIT is B12 absorbed?
terminal ileum
What is pernicious anaemia?
- autoimmune disorder affecting GIT (antibodies present)
- causes malabsorption of B12
- can lead to macrocytic megaloblastic anaemia
Give 2 examples of hypochromic microcytic anaemia
- Iron Deficiency Anaemia
2. Thalassaemia
List some of the possible causes of IRON-DEFICIENCY anaemia
- lack of iron dietary intake
- loss of iron in GIT
- malabsorption
- — partial gastrectomy
- — coeliac disease
- — crohn’s disease
- any cause of long-standing severe diarrhea
List some of the common clinical features/presentations of IRON-DEFICIENCY anaemia
- mucosal pallor
- angular cheilitis
- atrophic glossitis (smooth tongue)
- brittle nails
- koilonychia (spoon nails)
- ice pica
If there is a patient over the age of 50 with iron deficiency anaemia, what MUST be done?
- duodenal biopsy
- upper and lower GI endoscopy
What is the treatment of iron deficiency anaemia?
oral Iron (IV if they can’t tolerate it)
Give 2 main causes of megaloblastic anaemia
- B12 Deficiency
2. Folate Deficiency
What are megaloblasts?
- enlarged RBCs due to retarded RBC synthesis
- nucleus is enlarged compared to cytoplasm
What vitamin is Cobalamin?
Vitamin B12
Explain the process by which vitamin B12 is absorbed
- intrinsic factor released from gastric parietal cells
- B12 from diet combines with IF
- B12-IF complex formed
- complex absorbed in terminal ileum
Pernicious anaemia can cause vitamin B12 deficiency. Which 2 antibodies may be present?
- Antibody to IF
2. Antibody to Gastric Parietal Cells
List some of the possible causes of B12 DEFICIENCY anaemia
- lack of IF
- – pernicious anaemia
- – atrophic gastritis
- – partial gastrectomy
- malabsorption
- – Crohn’s disease
- – loss of terminal ileum
- blind loop bacteria (compete for B12)
List some of the clinical features/complications of B12 deficiency
- peripheral neuropathy
- subacute combined degeneration of the cord
- optic atrophy
- psychiatric disorder
- atrophic glossitis
If a chronic alcoholic presents with a confusion disorder, which anaemia is the most likely cause?
B12 Deficiency Anaemia
What is the treatment for B12 deficiency anaemia?
- Parenteral B12 (intramuscular injection)
2. Folate given at same time`
List some of the causes of folate deficiency which would cause anaemia
Malabsorption:
- Coeliac disease
- Crohn’s disease
- pregnancy*
- resection of small bowel
- blind loop syndrome
When looking at the histology of a patient with Coeliac disease - what can be seen in their intestines?
- blunting of villi
- closing off of crypts
impaired villi = decreased absorption
