Microcytic Anaemia Flashcards
(69 cards)
What is microcytic anaemia?
low MCV indicating small RBCs
What are the causes of microcytic anaemia?
TAILS
T – Thalassaemia A – Anaemia of chronic disease I – Iron deficiency anaemia L – Lead poisoning S – Sideroblastic anaemia (congenital)
a history of a normal haemoglobin level associated with a microcytosis, In patients not at risk of thalassaemia, consider what diagnosis?
polycythaemia rubra vera which may cause an iron-deficiency secondary to bleeding.
New onset microcytic anaemia in elderly patients is a normal sequelae in ageing
FALSE
New onset microcytic anaemia in elderly patients should be urgently investigated to exclude underlying malignancy.
in beta-thalassaemia minor the microcytosis is often disproportionate to the anaemia
true
What is the most common anaemia worldwide?
Iron deficiency anaemia
Pathophysiology of Iron deficiency anaemia
Iron is needed to make the haemoglobin in red blood cells, therefore a deficiency of iron leads to a reduction in red blood cells/haemoglobin i.e. anaemia.
Iron deficiency anaemia has the highest incidence amongst
preschool-age children.
What are the main causes of iron deficency anaemia
excessive blood loss
inadequate dietary intake
poor intestinal absorption
increased iron requirements.
What are some common causes of non-acute excessive blood loss?
blood loss due to menorrhagia is the most common cause in pre-menopausal women
gastrointestinal bleeding is the most common cause in men and post-menopausal women.
What should you always suspect in someone with gi bleeding
colon cancer
vegans always get iron def anemia
dark green leafy vegetables are another good source of iron, therefore people who don’t eat meat can still receive enough iron through purely dietary sources
Who has increased iron requirements?
children have increased iron demands during periods of rapid growth
Pregnancy as the baby will receive their iron supply from the mother
Also an increase in plasma volume during pregnancy causes iron deficiency anaemia through dilution i.e. the proportion of fluid in comparison to red blood cells increases.
What are symptoms of iron defiency anaemia?
Fatigue
Shortness of breath on exertion
Palpitations
Pallor
What signs are pathonogmonic of iron defiency anaemia?
Nail changes: this includes koilonychia (spoon-shaped nails) Hair loss Atrophic glossitis Post-cricoid webs Angular stomatitis
What should you ask about in a hx for iron defiency anaemia?
changes in diet medication history menstrual history weight loss change in bowel habit
Full blood count (FBC) demonstrates what in iron defiency anaemia?
hypochromic microcytic anaemia
Iron studies will show what in iron defiency anaemia?
Serum ferritin this will likely be low
Total iron-binding capacity (TIBC)/transferrin this will be high
transferrin saturation will however be low
Why is serum ferritin low in iron defiency anaemia?
serum ferritin correlates with iron stores
Why might serum ferritin be raised in iron defiency anaemia?
ferritin can be raised during states of inflammation
For patients with co-occurring inflammatory disease, other iron studies can be performed.
What does a high TIBC/transferrin reflect?
low iron stores
What will blood film show in iron defiency anaemia?
anisopoikilocytosis (red blood cells of different sizes and shapes)
target cells
‘pencil’ poikilocytes
Endoscopy is routinely done in iron-deficiency anaemia
false
males and post-menopausal females who present with unexplained iron-deficiency anaemia should be considered
In iron defieincy canaemia who should be refered to a GI specialist? How soon?
Post-menopausal women with a haemoglobin level ≤10
men with a haemoglobin level ≤11
within 2 weeks.
