Microcytic, hypochromic anaemia Flashcards Preview

TCA 11 - Anaemia > Microcytic, hypochromic anaemia > Flashcards

Flashcards in Microcytic, hypochromic anaemia Deck (31)
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1

What does high hepcidin cause?

Ferroportin (Fe+ transport protein) degrades
Prevents iron release from enterocytes into bloodstream and trapping of iron in marrow macrophages

2

What increases hepcidin release?

IL-6 and high transferrin (allows iron to be transferred in blood) saturation

3

What does a decrease in hepcidin cause?

Promotes iron absorption from the gut and release from the marrow macrophages to assist in erythropoiesis

4

Why do patients with chronic haemolysis become iron overloaded?

High levels of growth differentiation factor 15 (GDF15) inhibits hepcidin

5

What causes iron-deficiency anaemia?

1. Inadequate iron-containing foods in the diet
2. Malabsorption (coeliac disease, milk, tea)
3. Blood loss
4. Hookworm

6

What is the most common cause of iron-deficiency anaemia in toddlers?

Cow's milk

7

What is the most common cause of iron-deficiency anaemia in pre-menopausal females?

Menorrhagia
15% of Caucasian women have vWD

8

What is the most common cause of iron-deficiency anaemia in men and post-menopausal women?

GI bleeds
- Colonic and gastric cancers must be excluded
- NSAIDs and aspirin

9

What is pica in iron-deficiency anaemia?

Craving non-food items to eat

10

What diagnoses iron-deficiency anaemia?

- Low Hb
- Decreased MCV
- Decreased MCH
- Decreased MCHC
- Microcytic, hypochromic anaemia with anisocytosis and poikliocytosis
- Decreased ferritin (iron stores)

11

What is anisocytosis?

Different cell sizes

12

What is poikilocytosis?

Oddly shaped cells

13

What can make ferritin levels increase?

It is an acute reactant protein
- Inflammation

14

What can make ferritin levels decrease?

Infancy
Adolescence

15

How would you treat iron-deficiency anaemia

Ferrous sulphate 200mg 2/3 times per day
Continue for 3 months

16

When would you continue a patient on ferrous sulphate after the 3 months?

200mg o.d.
• Recurring anaemia
• Iron-poor diet
• Malabsorption
• Menorrhagia
• Had a gastrectomy

17

What are the side effects of ferrous sulphate?

- GI discomfort
- Constipation/diarrhoea
- Black stools

18

What drug would you change to if the side effects of ferrous sulphate are too much?

Ferrous fumarate

19

What can ferrous sulphate reduce the absorption of?

- Quinolone
- Tetracyclines
- Levodopa
- Bisphosphonates
- Zinc
- Levothyroxine
- Calcium products

20

How do you monitor iron-deficiency anaemia?

Check Hb levels 2-4 weeks after supplementation
- Hb should rise by 2g/100mL over 3-4 weeks

21

What is thalassaemia?

Defects in alpha or beta chain of Hb.

22

What is thalassaemia's pattern of inheritance

Autosomal recessive

23

What type of anaemia is thalassameia?

Microcytic and haemolytic

24

What diagnoses thalassaemia?

- Low Hb
- Microcytic, hypochromic RBCs with anisocytosis and poikilocytosis
- Hb electrophoresis
- DNA testing
- HbA2
- HbF
- Genetic testing

25

What is thalassaemia trait/minor?

One abnormal beta gene
Raised HbA2

26

What is thalassaemia intermedia?

Synthesis of beta chains are less severely reduced

27

What is thalassaemia major?

2 abnormal beta genes so have no HbA

28

What are signs of thalassaemia major?

- Abdominal swelling
- Growth retardation
- Irritability
- Jaundice
- Pallor
- Skeletal abnormalities
- Splenomegaly

29

What does 3 deleted alpha Hb genes cause?

HbH
Microcytic anaemia, haemolysis and splenomegaly

30

What does 4 deleted alpha Hb genes cause?

HbBarts
Fatal hydrops fetalis