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Flashcards in Anaemia Deck (15):
1

When would you see high reticulocytes in anaemia?

When the anaemia is due to increased removal of Hb:
- Haemorrhage
- Haemolysis eg. Sickle cell, hereditary sherocytosis/eliptocytosis, pyruvate kinase deficiency, G6PD deficiency
- Splenic sequestration (splenomegaly)

2

When would you see low reticulocytes in anaemia?

When the anaemia is due to decreased Hb production

3

Give some causes of microcytic anaemia

Thalasaemia
Anaemia of chronic disease
Iron deficiency
Lead
Sideroblastic anaemia

4

Give some causes of iron deficiency anaemia

Reduced intake - vegetarians
Increased loss - GI bleed, heavy periods
Excessive use - pregnancy

5

Give causes of macrocytic anaemia

Vitamin B12 deficiency
Folate deficiency
Alcoholism
Hypothyroidism

6

Give causes of vitamin B12 deficiency

Low intake - vegans
Pernicious anaemia (low intrinsic factor)
GI surgery

7

Give causes of folate deficiency

Poor diet
Malabsorption
Drugs (anticonvulsants)

8

Give causes of normocytic anaemia

Anaemia of chronic disease
Renal failure
Mixed deficiency (ie. Iron and vitamin B12)
Bone marrow failure

9

Pathophysiology of anaemia of chronic disease

In chronic inflammation cytokines are released, stimulate excess HEPCIDIN.
This reduces gut iron absorption and reduces iron release by macrophages

10

Symptoms of anaemia

Fatigue & lethargy
Weakness
Shortness of breath
Palpitations
Headaches

Severe: angina, HF, claudication, confusion, dizziness

11

Signs of anaemia

Pallor
Tachycardia
Systolic flow murmur
Glossitis
Angular stomatitis
Leg ulceration
Koilonychia
Pale conjunctiva

12

Questions to ask in anaemia history

Diet: vegan/vegetarian?
Past surgery?
Family history?
Past medical history?

13

Investigations in anaemia

Blood film: spherocytosis? Mean cell volume? Reticulocytes?
Blood test: ferritin levels, transferrin saturation, VitB12 and folate levels, EPO, bilirubin, LFTs, Direct Coombs test

14

Management of anaemia

Treat underlying cause
- Iron deficiency: give dietary advice and oral iron supplements
- ACD: EPO, transfusion

15

Define anaemia

Reduced haemoglobin concentration in the blood <130g/L, leading to reduced O2 delivery to cells