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11 Cards in this Set
- Front
- Back
What diagnoses would you consider for a blood film showing microcytic blood cells?
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Thalassemia
Iron deficiency Chronic disease Sideroblastic anaemia |
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What diagnoses would you consider for a blood film showing normocytic blood cells?
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Renal failure
Aplastic anaemia Chronic disease Haemolysis / Haemorrhage |
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What diagnoses would you consider for a blood film showing macrocytic blood cells?
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Vitamin B12 deficiency
Folate deficiency Liver disease Drug side effects |
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What causes pernicious anaemia?
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Pernicious anaemia is an autoimmune disorder where the gastric mucosa is destroyed and hence Intrinsic Factor production is reduced.
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Describe the dietary sources of:
- Vitamin B12 - Folate - Haem iron - Ferrous iron |
Vitamin B12 is from meat products only.
Folate is from green vegetables and some meat products. Haem iron is from animal products and is well absorbed. Ferrous iron (non-haem) is from plant sources and is quite poorly absorbed. |
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Why is homocysteine a useful measure of megaloblastic anaemia?
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Because Vit B12 converts homocysteine to methionine and therefore a deficiency in B12 would cause homocysteine levels to be reduced.
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At the cellular level, what fault is present in megaloblastic anaemia, and why?
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Impaired DNA synthesis is the fault. This causes the cell to remain large and immature (reticulocytes). The impairment is due to the lack of folate and B12 which are required to synthesise DNA.
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Explain how renal failure can cause anaemia.
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EPO is produced in the kidney and in renal failure this production is impaired. Therefore, EPO is unavailable to stimulate erythopoiesis, resulting in an aplastic anaemia.
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What diagnostic tests would you order for a suspected case of anaemia?
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1. Blood film
2. FBC 3. Iron studies + Ferritin 4. Trephine (2nd line) 5. Electrophoresis (2nd line) |
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Myelodysplastic syndromes can cause what type(s) of anaemia?
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Normocytic or Macrocytic
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What are the presenting symptoms of anaemia?
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Weakness / Fatigue
Dyspnoea Bruising / Bleeding Recurrent infection Postural dizziness Skin rash Tachycardia Dark urine Lymphadenopathy |