nutritional anaemia

Question 1

definition of anaemia

Answer 1

no. of RBCs (consequently the O2 carrying capacity) is insufficient to meet the bodies physiological needs

Question 2

haemoglobin

Answer 2

iron containing O2 transport metalloprotein within RBCs

Question 3

components of blood

Answer 3

RBCs, platelets, WBCs

Question 4

example of difference in Hb levels when diagnosing anaemia

Answer 4

differs in age, gender, physiological state e.g. pregnant

Question 5

eythropoesis

Answer 5

maturation of RBC from erythropoietic stem cell

Question 6

what is required for normal erythropoiesis to take place?

Answer 6

vitamin B12 & folic acid, DNA synthesis, Iron, Hb synthesis

Question 7

3 main mechanisms of action of anaemia

Answer 7

1. Failure of production (hypoproliferation, reticulocytopenic)
2. Ineffective Erythropoiesis
3. Decreased survival (haemolysis, reticulocytosis)

Question 8

Reticulocytopenic

Answer 8

Abnormal decrease of reticulocytes in the body. Reticulocytes are new, immature red blood cells.

Question 9

Reticulocytosis

Answer 9

Increase in reticulocytes

Question 10

Haemolysis

Answer 10

Rupture or destruction of RBCs

Question 11

Mean Cell Volume (MCV)

Answer 11

describes average RBC size

Question 12

Microcytic

Answer 12

small, hypochromic RBCs

- e.g. iron deficiency, thalassaemia, anaemia of chronic disease

Question 13

Normocytic

Answer 13

normal sized RBCs, but a low number
- e.g. anaemia of chronic disease, aplastic anaemia, chronic renal failure, bone marrow infiltrations sickle cell disease

Question 14

Macrocytic

Answer 14

large sized RBCs

- e.g. B12/Folate deficiency, Myelodisplasia, Alcohol/Drug induced, Liver disease, Myxoedema

Question 15

Nutritional Anaemia

Answer 15

Anaemia caused by lack of essential ingredients that the body requires, e.g. Iron, Folate & B12 deficiency

Question 16

where is iron absorbed?

Answer 16

duodenum

Question 17

what is transferrin?

Answer 17

Transferrins are iron-binding blood plasma glycoproteins that control the level of free iron (Fe) in biological fluids.

Question 18

what is Ferritin?

Answer 18

storage of iron: when there is excess iron (will be low in iron deficiency)

Question 19

how is iron absorption regulated?

Answer 19

by hepcidin, via ferroportin receptors on enterocytes

Question 20

Action of hepcidin

Answer 20

degrades ferroportin, decreasing iron transfer from blood plasma from duodenum

Question 21

causes of iron deficiency

Answer 21

• not enough in diet, malabsorption

- excess loss, e.g. blood loss

Question 22

normochromic

Answer 22

normal concentration, but insufficient number of RBCs

Question 23

symptoms of iron deficiency anaemia

Answer 23

fatigue, lethargy & laziness

Question 24

signs of iron deficiency anaemia

Answer 24

pallor of mucous membranes, bounding pulse, systolic flow murmurs, smooth tongue, koilonchias

Question 25

megaloblastic macrocytic anaemia

Answer 25

vitamin b12/folate deficiency: RBCs larger than normal

Question 26

nonmegaloblastic macrocytic anaemia

Answer 26

no impairment of DNA synthesis: due to alcoholism, hypothyroidism, liver disease

Question 27

source of B12

Answer 27

animal & dairy produce

Question 28

source of folate

Answer 28

vegetables, liver

Question 29

importance of vitamin B12 & folic acid

Answer 29

final maturation of RBC and DNA synthesis, for thymidine triphosphate synthesis

Question 30

peripheral smear of B12 & Folic acid deficiency

Answer 30

macroovalocytes & hypersegmented neutrophils

Question 31

folate uses

Answer 31

Adenosine, guanine and thymidine synthesis

Question 32

vitamin B12 uses

Answer 32

Essential co-factor for methylation in DNA and cell metabolism

Question 33

how is vitamin B12 absorbed

Answer 33

requires the presence of intrinsic factor for absorption in the terminal ileum (IF is made in parietal cells in the stomach)

Question 34

how is vitamin B12 transported

Answer 34

Transcobalamin II and Transcobalamin I transport vitB12 to tissues

Question 35

clinical consequences of VitB12 & Folic acid deficiency

Answer 35

``` Brain: cognition, depression, psychosis Neurology: myelopathy, sensory changes, ataxia, spasticity (SACDC) Infertility Cardiac cardiomyopathy Tongue: glossitis, taste impairment Blood: Pancytopenia ```

Question 36

what is pernicious anaemia?

Answer 36

autoimmune disoder, with a lack of IF - reduced B12 absorption IF antibodies

Question 37

treatments for anaemia

Answer 37

Iron – diet, oral, parenteral iron supplementatin, stopping the bleeding Folic Acid – oral supplements B12 – oral vs intramuscular treatment