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Flashcards in Microcytic anaemia Deck (22):
1

What are the microcytic anaemias

Anaemia of chronic disease
Iron deficiency anaemia
Sideroblastic anaemia
Haemoglobinopathies - thalassaemia

3

Causes of anaemia of chronic disease

Chronic inflammation e.g RA
Neoplasia
Renal failure

4

Blood test abnormalities in anaemia of chronic disease

Low EPO
Low iron
High/normal ferritin
Low/normal soluble transferrin receptor number

5

Appearance of erythrocytes in anaemia of chronic disease

Microcytic
Hypochromic

6

Causes of iron deficiency anaemia

Blood loss
Poor dietary intake
Malabsorption in duodenum - chron's, coeliac's

7

Clinical features of iron deficiency anaemia

Koilonychia
Angular stomatitis
Brittle hair and nails (hair thinning/loss)
Atrophic glossitis

8

Blood test abnormalities in iron deficiency anaemia

Low iron
Low ferritin
High soluble transferrin receptor number

9

Erythrocytes appearance in iron deficiency anaemia

Microcytic
Hypochromic

10

Investigations for iron deficiency anaemia

Colonoscopy
Gastroscopy

11

Treatment for iron deficiency anaemia

Ferrous sulphate tablets TDS
If malabsorption underlying cause, give iron injections

12

Causes of sideroblastic anaemia

Congenital
Isoniazid
Myelodysplasia
Alcohol
Lead

13

Pathophysiology of sideroblastic anaemia

Dyserythropoeisis (ineffective erythropoeisis)
Haemosiderosis

14

Blood test abnormalities in sideroblastic anaemia

High serum iron
High ferritin

15

Treatment for sideroblastic anaemia

Treat underlying cause
Can give pyridoxine (vitamin B6)
Blood transfusion in severe haemosiderosis

16

Treatment of anaemia of chronic disease

Not responsive to oral iron
Need to treat underlying cause e.g give EPO

17

Appearance of bone marrow in sideroblastic anaemia

BM contains ringed sideroblasts
Cytoplasm contains iron granules

18

Where is dietary iron absorbed

Duodenum

19

How to diagnose haemoglobinopathies

Hb electrophoresis

20

Beta thalassaemia trait/minor vs intermedia vs major

Trait/minor: usually asymptomatic, well tolerated anaemia

Intermedia: moderate anaemia not requiring transfusions, there may be splenomegaly

Major: presents at <1 year with severe anaemia and failure to thrive, need life long blood transfusion

21

Features of beta thalassaemia major

Extramedullary haemotopoeisis - hepatosplenomegaly and skull bossing
Increased marrow activity - osteopenia and 'hair on end' sign on skull X-ray

22

What is beta thalassaemia major

Abnormalities in both beta globin chains leads to absent HbA (alpha2-beta2)

23

Describe the 4 types of alpha thalassaemia

1 gene deleted: clinically normal
2 genes deleted: asymptomatic carrier
3 genes deleted: HbH disease, beta chain tetramers, moderate anaemia, symptoms of haemolysis (jaundice, hepatosplenomegaly, leg ulcers)
4 genes deleted: death in uterine