Flashcards in Anaemia Deck (19):
Decribe the creation of an erythrocyte
hemocytoblast --> proerythroblast --> normoblast --> reticulocyte --> erythrocyte
How do the kidneys regulate erythropoeisis?
erythropoeitin released in hypoxic conditions. eyrhtropoietin acts on bone marrow to increase number of erythrocyte progenitor cells.
What 2 metabolic pathways are found in the RBC? What can abnormalities in these pathways lead to?
Embden-Meyerhof Pathway - glucose metabolised to lactate to produce ATP. Used to maintain membrane pumps.
Hexose monophosphate pathway - G6P used to generate NADPH.
abnormalities lead to anaemia
define anemia in adult men and women
How does the body respond to anemia?
Increasing CO, produce more 2,3-BPG, increasing erythropoeisis,
What are the symptoms of anemia?
dyspnoea, weakness and lethargy, palpitations, headaches, tachycardia, pallor
What are the 2 ways anaemia can occur?
reduced production or increased removal
how can anemia be classified?
High (due to hemorrhage or hemolysis) and low reticulocytes (reduced production)
How would you test for hemolysis? What would each test show?
Blood films - show spherocytosis, red cell fragments etc
Direct coombs test - tests for autoimmune hemolysis
Bilirubin levels or LDH levels
haptoglobin - used to remove Hb from blood by spleen
How can low reticulocyte anemia be further subclassified?
microcytic, normocytic, macrocytic
Name 5 main causes of microcytic anemia
Thalassemia, anaemia of chronic disease, iron deficiency, lead, sideoblastic anemia
How would you confirm iron deficiency anemia
ferritin and transferrin % saturation tested.
Name causes of normocytic anemia
anaemia of chronic disease, renal failure, bone marrow failure
Explain the pathogenesis of anemia of chronic disease
In chronic disease there is chronic inflammation. Inflammation produces IL-6 which stimulates increased hepcidin which reduces amount of ferroportin in blood.
Hepcidin reduces iron absorption in gut.
name causes of macrocytic anemia
b12 or folate deficiency, hypothyroidism, alcoholism.
When would b12 deficiency be seen?
vegetarians, pernicious anemia, iliac disease or surgery
when would folate deficiency be seen?
poor diet, malabsorption, drugs
What would anaemia of chronic disease show during investigations which are different to iron deficiency anaemia?
Increased ferritin levels, raised inflammatory markers, low % transferrin saturation