Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

4th Year Haematology > Normocytic anaemia > Flashcards

Normocytic anaemia Flashcards

(41 cards)

Start Studying
1
Q

Causes of normocytic anaemia

A
  • Acute blood loss
  • Haemolytic anaemia
  • Anaemia of chronic disease
  • Chronic kidney disease
  • Aplastic anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the two mechanisms of normocytic anaemia and how do you differentiate the two?

A

Increased destruction (haemolysis) = Increased reticulocytes

or

Reduced production (bone marrow failure) = Reduced reticulocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of normocytic anaemia with increased reticulocytes

A
  • Hereditary
    • Hereditary spherocytosis
    • Sickle cell anaemia
    • Glucose-6-phosphate dehydrogenase deficiency
    • Pyruvate kinase deficiency

Acquired

  • Autoimmune haemolytic anaemia
  • Paroxysmal nocturnal haemoglobinuria
  • Micro/macroangiopathic haemolytic anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of normocytic anaemia with reduced reticulocytes

A
  • Chronic renal failure
  • Aplastic anaemia
  • Myelophthisic process
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Symptoms of anaemia

A
  • Fatigue
  • SOB on exertion
  • Chest pain
  • Palpitations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Signs of anaemia

A
  • Tachycardia
  • Tachypnoea
  • Hypotension
  • Pallor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

General investigations in anaemia

A

Bedside

  • Full set of observations

Bloods

  • FBC: reduced Hb. Assess MCV
  • Blood film
  • Iron studies
  • B12 and folate levels
  • Haemolysis screen: bilirubin, haptoglobin, Coombs test
  • U&Es: CKD
  • TFTs: hypothyroidism
  • LFTs: chronic liver disease

Imaging

  • Assess for site of blood loss

Special tests

  • Bone marrow biops
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Definition of hereditary spherocytosis

A

Inherited defect in RBC membrane proteins leading to a haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Epidemiology of hereditary spherocytosis

A
  • Northern European and North American populations
  • 1 in 2000 people
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical features of herediatary spherocytosis

A
  • General features of anaemia
  • Neonatal jaundice
  • Splenomegaly
  • Gallstones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Investigations in hereditary spherocytosis

FBC

Blood film

LFTs

LDH

A
  • FBC: normocytic anaemia
    • Raised reticulocyte count
  • Blood film: spherocytes
  • LFTs: raised bilirubin
  • LDH: raised
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Managment of hereditary spherocytosis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define sickle cell anaemia.

What is meant by sickle cell disease, sickle cell trait and sickle cell crisis?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Epidemiology of sickle cell disease

A
  • Sickle cell trait: highest incidence in Sub-Saharan Africa
  • 8% of Afro-Caribbean people carry the sickle cell gene
    • Protective against falciparum malaria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical features of sickle cell anaemia

A
  • General features of anaemia
  • Jaundice
  • Failure to thrive
  • Frontal bossing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Types of sickle cell crisis

A
  • Sequestration crisis
  • Aplastic crisis
  • Haemolytic crisis
  • Vaso-occlusive crisis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Features of sequestration crisis

18
Q

Features of aplastic anaemia

Study These Flashcards
A
  • Infection with parovirus B19
  • Bone marrow suppression with reduced reticulocyte count
19
Q

Features of haemolytic crisis

Study These Flashcards
A
  • Usually occurs in context of vaso-occlusive crisis
  • Increased haemolysis
  • Decreased Hb and increased reticulocytes
20
Q

Features of vaso-occlusive crisis

21
Q

Precipitants of vaso-occlusive crisis

Study These Flashcards
A
  • Infection
  • Dehydration
  • Hypoxia
  • Acidosis
22
Q

Investigations for sickle cell anaemia

Study These Flashcards
A
  • Newborn screening: Guthrie heel prick test
  • FBC:
    • Normocytic anaemia (MCV 80-95fL)
    • Increased reticulocytes
  • Blood film: sickle cells, Howell-Jolly bodies
  • Hb electrophoresis
23
Q

Genes affected, HbA, HbA2, HbF and HbS proportion in sickle cell trait and sickle cell disease

Study These Flashcards
A

Trait: 1 gene; HbA 55%, HbA2 2%, HbF <2%, HbS 40%

Disease: 2 genes; HbA 0%, HbA2 2%, HbF 8%, HbS 90%

24
Q

Investigations in sickle cell crisis

25
Management of sickle cell crisis
* Supportive * **Oxygen** * **Analgesia:** often requires opiates * **Rehydration:** dehydration precipitates sickling * **Antibiotics:** particularly in chest crisis * **Chest physiotherapy** * **Blood transfusion:** in a severe crisis a blood transfusion reduces the proportion of HbS * **Exchange transfusion:** involves removal of HbS in exchange for normal Hb in a life threatening crisis eg organ damage
26
Long term management of sickle cell disease
* **Avoid precipitants:** eg infections, dehydration, hypoxia, cold * **Pain managment:** regularly prescribed medications to manage chronic pain * **Hydroxycarbamide:** increases HbF; indicated for patients with recurrent chest or pain crisis * **Folic acid supplementation:** 5mg once weekly * **Lifelong phenoxymethylpenicillin:** patients are at risk of infection from encapsulated bacteria due to hyposplenism from autosplenectomy * **Regular vaccinations:** pneumococcal vaccine every 5 years and annual influenza
27
Definition of G6PD deficiency
Inherited X-linked recessive disorder resulting in a haemolytic anaemia. (Results in reduced half life of RBCs)
28
Epidemiology of G6PD deficiency
* African, Mediterranean and Asian ethnicity * Prevalence of 50-70% in Kurdish Jews * Protetive role against malaria
29
What is the life span of a red blood cell?
120 days
30
What does G6PD do?
It protects the cells from oxidative damage. Red cells are particularly prone to oxidative stress.
31
Investigations in G6PD deficiency
32
Managment of G6PD deficiency
* Neonatal jaundice * Phototherapy or exchange transfusion * Blood transfusion * Hb \<70g/L or * Hb \<80g/L and cardiac co-morbidity * Folic acid * Daily until splenectomy * Splenectomy * Spleen removal reduces haemolysis * Delayed until patients are \>6 years of age to reduce the risk of post splenectomy sepsis
33
Define autoimmune haemolytic anaemia
**Antibody mediated destruction of RBCs.** Divided into cold and warm depending on what temperature the anatibodies most avidly bind RBCs.
34
Difference in pathophysiology between warm and cold autoimmune haemolytic anaemia.
* Warm: IgG binds RBCs; Extravascular haemolysis * Cold: IgM binds RBCs; Extravascular and intravascular haemolysis
35
Causes of warm autoimmune haemolytic anaemia
* Idiopathic * SLE * CLL * Drugs * Penicillins * Cephalosporins
36
Causes of cold autoimmune haemoglobin anaemia
* Idiopathic * M. Pneumoniae * EBV
37
Investigations in autoimmune haemolytic anaemia
* Bloods * FBC: * Normocytic anaemia (MCV 80-95fL) * Increased reticulocytes * Blood film: spherocytes * LFTs: bilirubin raised * LDH: raised * Haptoglobin: reduced * Special test * Coombs test * Direct * Indirect * Cold aggltinin titre
38
Managment of haemolytic anaemia
* Treat underlying cause * Avoid cold in cold agglutinin disease * Blood transfusion * Immunosupressants * Plasmapheresis * Splenectomy
39
Why does normocytic anaemia occur in chronic renal failure?
Decreased production of RBCs due to reduced EPO
40
Pathophysiology of aplastic anaemia
41
Myelophthisic process
Process which replaces bone marrow eg malignancy

4th Year Haematology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions