Anaemia

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different types, causes and treatments of anaemia
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What is a macrocytic anaemia? What are the causes? MCV >96, reduced Hb. megaloblastic/ normoblastic anaemia, B12 or folate deficiency, excess alcohol, haemolytic disease, liver disease, hypothyroidism.
What is a normocytic anaemia? What are the causes? MCV normal, reduced Hb. Acute blood loss, chronic disease, marrow infiltration/fibrosis, endocrine disease, combined deficiency
What is a microcytic anaemia? What are the causes? MCV <80, reduced Hb. iron deficiency, chronic disease, thalassaemia, sideroblastic anaemia.
What is the presentation of anaemia? Chronic- insidious, generalised fatigue, pale skin. More acute- breathlessness, angina pectoris, mild claudication, systolic murmur, tachycardia.
What is the normal Fe2+ absorption pathway? Fe2+ in food, dissolves in low pH of stomach, ferrireductase reduces to ferrous form, absorbed by mucosal cells
What is anaemia of chronic disease? Micro/normocytic anaemia. Occurs in pts with chronic inflammatory conditions. Tx with recombinant erythropoietin
What is sideroblastic anaemia? Rare microcytic anaemia. Disorder in haem synthesis. Inherited or acquired (alcohol). Tx with vit B6 and underlying cause.
What is pernicious anaemia? Autoimmune macrocytic anaemia. Atrophic gastritis causes parietal cell death, so lack of INTRINSIC factor.
What is the presentation? How would you treat it? Insidious onset. Symptoms include glossitis, angular stomatitis, mild jaundice. IM hydroxocobalamin, oral B12.
What is aplastic anaemia? What are the causes? What's the treatment? Macrocytic anaemia due to deficiency of ALL cell elements. Reduction of stem cells. Congenital, idiopathic, HIV, HEP, TB, preg. Transfusion/transplant, ciclosporin.
What is haemolytic anaemia? What are the causes? Normocytic anaemia. Increased lysis of RBCs due to inherited Hb/membrane defects, systemic disease or autoimmune causes
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