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Look over this nice picture of blood cells
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Define anaemia + the different types
Anaemia = Hb <125g/dL
Microcytic -> low MCV -> defective haemoglobinisation
Macrocytic -> MCV >100 -> Defective DNA synthesis
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What are the causes of Microcytic anaemia?
TAILS
- Thalassaemia
- Anaemia of Chronic disease
- IDA
- Lead Poisoning
- Sideroblastic anaemia
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For IDA give;
-3 CF
-2 causes
-Ix
-Mx
CF
Spooned nails, angular stomatitis, atrophic glossitis [pale & painless], Oesophageal web [Plummer-Vinson syndrome]
Causes;
- Blood loss -> GI until proven otherwise
- Malabsorption -> Gastric acid req for release, abs in small intestine [Coeliac]
- ^^Physiological demand -> pregnancy, infancy, puberty
Ix -> low Serum ferritin, TF saturation <16%
Mx -> Treat cause, Ferrous fumerate
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What are the investigation results of Anaemia of chronic disease?
- Film -> normocytic, normochromic, RBC rouleuax
- ^ESR
- N/^Serum ferritin
- Total iron binding capacity = low
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Breifly outline B-Thalassaemia
AR inherited disorder of globin genes [missing one]
CF -> dyserythropoeisis, hair on end skull XR, anaemia + spleenomegaly
Mx -> Blood transfusion + chelation therapy
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Give 4 causes of Marocytic anaemia?
Defective DNA synthesis;
- B12 deficit
- Folate deficit
- Cytotoxic drugs
- Myelodysplasia
Other;
- Marked reticulocytosis
- Elevated plasma lipid -> alcohol, pregnancy, hypothyroidism
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Ix of Macrocytic anaemia?
- Hb = low
- MCV >120
- Blood film
- SF = elevated
- Plasma LDH = elevated
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Outline B12 deficiency and give 3 causes?
B12 [Cobalamin]
bound to intrinsic factor -> abs in terminal ileum
causes:
- Diet deficit -> strict vegans, rare
- Gastric factors -> impaired acid secretion
- Pernicious anaemia -> autoimmune destruction of parietal cells [no intrinsic factor]
- small bowel -> ceoliac, IBD, tapeworms
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Outline folate deficiency and causes?
Required for DNA synthesis
Causes:
- diet -> poor green leafy vegetables
- Malabsorption -> Coeliac diasease
- ^^demand state -> pregnancy, cell proliferation
- Drugs -> phenytoin, OCP, MTX [only worsen existing deficit]
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Outline the congenital anc acquired causes of haemolytic anaemia. Give 2 for each.
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