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Flashcards in Anaemia Deck (24)
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1

What is anaemia defined as?

A haemoglobin level below the normal range

2

What does the normal range of haemoglobin level vary with?

Age

3

Why are Hb levels higher in utero?

Mainly due to the higher oxygen affinity of HbF

4

What happens to Hb levels during the first few months of life?

They fall due to reduced red cell production

5

What happens to Hb after the first few months of life?

Levels stabilise until puberty

6

What might happen to Hb levels during puberty?

Growth leads to an increased demand for iron, and iron deficiency may develop, particularly in girls

7

What Hb level is considered anaemia in neonates?

<130g/L

8

What Hb level is considered anaemia in 1-12 months?

<100g/L

9

What Hb level is considered anaemia in 1-12 years?

<110g/L

10

What are the main mechanisms anaemia occurs through?

- Insufficient red cell production
- Excessive red cell destruction (haemolysis)
- Increased red cell loss (bleeding)

11

What should the investigation of anaemia start with?

A full blood count and blood film

12

What should be suspected if anaemia is associated with abnormalities in the white cell and platelet counts?

A bone marrow disorder, such as leukaemia, should be suspected

13

What provides the most useful information about the likely aetiology of anaemia if WCC and platelets are normal?

MCV and MCH

14

What kind of anaemia does iron deficiency result in?

Microcytic hypochromic anaemia (low MCV, low MCH)

15

What is an important differential for microcytic hypochromic anaemia?

ß-thalassaemia

16

When in particular is ß-thalassaemia an important differential for microcytic hypo chromic anaemia?

In children from the Indian subcontinent

17

What is found on investigation in ß-thalassaemia carriers?

MCH and MCV are low, but Hb only slightly reduced (80-100g/L)

18

What should be done when iron deficiency anaemia is suspected, in terms of testing?

Further test should be performed to confirm iron deficiency and rule out less common causes, such as thalassaemia and anaemia of chronic disease

19

What are the causes of microcytosis?

- iron deficiency
- Thalassaemia major or trait
- Anaemia of chronic disease

20

What are the causes of macrocytosis?

- Folate deficiency
- Vitamin B12 deficiency
- Diamond-Blackfan anaemia
- Liver disease
- Hypothyroidism

21

What happens to;
a. Hb level
b. MCV/MCH
c. Serum ferritin
d. TIBC
e. Serum transferrin receptor
f. Iron saturation
in iron deficiency

a. Hb level <100
b. MCV/MCH reduced
c. Serum ferritin reduced
d. TIBC increased
e. Serum transferrin receptor increased
f. Iron saturation reduced

22

What happens to;
a. Hb level
b. MCV/MCH
c. Serum ferritin
d. TIBC
e. Serum transferrin receptor
f. Iron saturation
in anaemia of chronic disease

a. Hb level 80-100
b. MCV/MCH normal or slightly reduced
c. Serum ferritin normal or increased
d. TIBC normal
e. Serum transferrin receptor normal
f. Iron saturation normal

23

What happens to;
a. Hb level
b. MCV/MCH
c. Serum ferritin
d. TIBC
e. Serum transferrin receptor
f. Iron saturation
in ß-thalassaemia major

a. Hb level <60
b. MCV/MCH very low
c. Serum ferritin normal
d. TIBC normal
e. Serum transferrin receptor normal
f. Iron saturation normal

24

What is the TIBC inWhat happens to;
a. Hb level
b. MCV/MCH
c. Serum ferritin
d. TIBC
e. Serum transferrin receptor
f. Iron saturation i
in ß-thalassaemia trait?

a. Hb level 80-100
b. MCV/MCH reduced
c. Serum ferritin normal
d. TIBC normal
e. Serum transferrin receptor normal
f. Iron saturation normal