Flashcards
Anaemias
Cards in this deck (14)
- 1Microcytic Anaemia: DDx:Microcytic Anaemia:
DDx:
Iron deficiency
Thalassaemia
Anaemia of chronic inflammation
Lead poisoning
Hyperthyroidism (very rare) - 2Blood film appearance if iron deficiency:Iron deficiency: Central pallor is ⅓ the normal diameter
- 3Anaemia of chronic inflammation: Causes: Pathophysiology: Result:Anaemia of chronic inflammation:
Causes: Infection/inflammation/malignancy
Pathophysiology: Cytokines of inflammation stimulate the liver to produce hepcidin which inhibits ferroportin on enterocytes in the intestine and macrophages resulting in reduced dietary iron absorption and sequestration of iron by macrophages respectively.
Result: Mild microcytic anaemia with elevated ferritin and reduced serum iron.
- 4Lead poisoning: Blood screen:Lead poisoning:
Blood screen: Prominent basophilic stippling (small dots at the periphery which are visualizations or ribosomes)
- 5Two types of thalassaemia:Thalassaemia:
Alpha thalassaemia
Beta thalassaemia - 6Alpha thalassaemia genotypes and phenotypes:
- 7Beta thalassaemia: Reduced synthesis of beta globin chains caused by either: Diagnosis based on:Beta thalassaemia:
Reduced synthesis of beta globin chains caused by either:
Reduced transcription (B+)
Absent transcription (B0)
Numerous mutations with variable severity in defect of chain synthesis
Deletions less common.
Range of severity from mild to severe.
Diagnosis: Increased HbA2 (a2y2) - 8B thalassaemia trait/minor: B thalassaemia intermedia: B thalassaemia major:B thalassaemia trait/minor:
Asymptomatic due to mild anaemia
MCV <72 fL
Blood film varies from almost normal with mild microcytosis and anisocytosis (not same size), hypochromia and poikilocytosis (weird shapes)
HbA2 3.6-5%
B thalassaemia intermedia:
Anaemia, splenomegaly, ulcers, bony deformity, occasional transfusion needed.
B thalassaemia major:
Dependent of blood transfusions.
Expanded bone marrow
Bony deformities
Hb 30-50 g/L
MCV 50-60 fL
MCH 12-18 pg
Iron overload-chelation therapy - 9Macrocytosis DDx:DDx:
Excess alcohol.
Liver disease (especially cholestatic)
B12/folate deficiency
Drugs
Cytotoxics
Phenytoin
Reticulocytosis
Haemolyosis
Hereditary haemochromatosis
Myeloma (sometimes)
Myelodysplastic syndrome
Anorexia Nervosa (sometimes can be microcytic due to iron deficiency)
Aplastic anaemia
Hypothyroidism - 10B12/folate deficiency: Collectively called: Megaloblastic refers to Folate deficiency causes: B12 deficiency (pernicious anaemia) causes:B12/folate deficiency:
Collectively called megaloblastic anaemia
Megaloblastic refers to the large abnormal erythroblasts in the bone marrow
Either:
Folate deficiency:
Dietary (alcoholics)
Malabsorption (Celiac)
B12 deficiency (pernicious anaemia):
Autoimmune atrophic gastritis
Vegan
Gastrectomy, small bowel pathology etc
- 11Haemochromatosis features on FBC:Haemochromatosis:
Increased MCV and Hb - 12Myelodysplastic syndrome blood film:Myelodysplastic syndrome:
Can have a mixture of hyper/hypochromic (dimorphic) but usually macrocytic on average - 13Reticulocytes:Reticulocytes:
Lose 20% of their volume in their first day of being in circulation
- 14Normocytic Anaemias: DDx:Normocytic Anaemias:
DDx:
Blood loss
Chronic renal failure (due to reduced EPO)
Chronic disease (tends towards macrocytic)
Haemolysis (tends towards macrocytic)
Myeloma (sometimes macrocytic)
Combinations (Iron+folate, iron+liver)
Anaemia of senescence
Sports’ dilutional anaemia
Pregnancy
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- Haematology Flashcards on Anaemias, created by Ashutosh Kumar on 05/04/2017.
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- Ashutosh Kumar
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