Flashcards in Week 3 HRM Deck (54)
What would the MCV value be in microcytic anemias?
What would the MCV value be in macrocytic anemias?
What would the MCV value be in normocytic anemias?
Name the 4 microcytic anemias
Iron deficiency, thalassemia, anemia of chronic disease and sideroblastic anemia
What is TIBC
Total iron binding capacity
What laboratory tests would be done for IDA?
Serum iron levels, TIBC, bone marrow iron stain, serum ferritin levels, RDW
What laboratory tests would be done for megaloblastic anemia?
Vitamin B12 and folate levels, liver and thyroid function test, bone a,row biopsy
What laboratory tests would be done for Hemolytic anemias?
Morphology, reticulocyte count, Coombs test( direct and indirect) Hb electrophoresis
What is the most common anemia?
Iron deficiency anemia
Name some common(aetiology) causes of IDA?
Bleeding, nutritional problems,worms, cancers, pregnancy, childhood
Discuss the pathogens is of IDA
Low Hb because of low iron, normal DNA with increased divisions due to hypoxia stimulating EPO. Iron is needed for cytochrome enzymes so epithelium is affected also. Smaller because there is less Hb
Describe the morphology of IDA
Microcytic, hypochromic, decreased central pallor, pencil cells, Anisocytosis and poikilocytosis
List some causes (aetiology) of megaloblastic anemia
Vitamin B12/ folate deficiency, gastritis, gastric atrophy(no intrinsic factor), cancer, old age, alcoholism, liver disease, hypothyroidism
Describe the pathogenesis of megaloblastic anemia
Abnormal DNA synthesis therefore there are decreased cell divisions
Affects WBCs and RBCs
List some clinical features of IDA?
Anemia, koilonychias(brittle spoon nails), esophagitis, glossitis (smooth shiny tongue), stomatitis, pale skin
List some clinical features of megaloblastic anemia
Stomatitis, anemia, jaundice, glossitis, chelates, neurological symptoms
Describe the morphology of megaloblastic anemia
Hypersegmented neutrophils, oval macrocytes, anisopoikilocytosis, polychromatophils, pancytopenia
Why do hyper segmented neutrophils disappear after only 14 days of treatment for megaloblastic anemia?
Because WBCs have a short lifespan and are replaced regularly
What is anemia of chronic diseas?
Anemia where iron is blocked from being stored in RBC precursors. The body has enough iron but it is unable to be accessed by the developing erythrocytes
What is the role of hepcidin in iron homeostasis?
It is a polypeptide produced by the liver that inhibits the release of iron from macrophages and intestinal epithelial cells via its interaction with the transmembrane iron transporter ferroportin
Why does inflammatory stimuli cause anemia in anemia of chronic disease?
Inflammatory stimuli activates monocytes and T cells, the T cells the Increase hepatic (liver) synthesis of hepcidin and decrease erythropoietin release . As this occurs, hepcidin inhibits iron release and erythropoiesis is also decreased.
Name some inflammatory mediators
IFN, TNF, IL-6
Describe some causes of anemia of chronic disease?
Rheumatoid arthritis, diabetes, Ct diseases, chronic infections, renal failure, inflammation, renal cell carcinoma
Describe clinical features of anemia of chronic disease?
Mild anemia, does not respond to nutritional supplements
Describe morphology of anemia of chronic disease?
Normal to microcytic cells, hypochromic
What are some lab roster indicators of anemia of chronic disease?
Having a chronic disease, low iron saturation and TIBC , reduced EPO and reticulocytes, increased ferritin
What is aplastic anemia?
Substantial reduction in number of haematopoietic stem cells and a fault in the remaining stem cells, that makes them unable to divide and differentiate sufficiently to populate the bone marrow. Replacement of marrow is by fatty yellow marrow
List some causes of aplastic snemia
Half cases are idiopathic, chemotherapy, toxic chemicals, radiation, viral infections, drugs
Clinical features of aplastic anemia?
Anemia, infections of throat and mouth, bleeding gums, bruising