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Questions and Answers
What laboratory values are typically decreased in anaemia?
Anaemia is classified as a disease.
False
Name two symptoms associated with anaemia.
Dizziness and fatigue.
Anaemia in the U.S. is signified by the _____ value.
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Match the type of anaemia to its cause:
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Which of the following is a cause of decreased RBC production?
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The reference intervals for Hb are the same for both males and females.
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What does PCV stand for?
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What does a decreased MCHC indicate?
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Sideroblastic Anaemia is classified as a normochromic macrocytic anaemia.
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What are the three morphological classifications of anaemia?
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The presence of spherocytes suggests that MCHC is __________.
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Which of the following is a cause of Normochromic Macrocytic Anaemia?
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In conditions of microcytic anaemia, MCV is less than the reference interval.
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List two disorders associated with hypochromic microcytic anaemia.
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Normocytic anaemias can be subdivided using the __________ count.
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Match the type of anaemia with its corresponding laboratory findings:
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Which of the following symptoms could indicate anaemia?
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What does a decreased Hb, PCV, and RBC count indicate?
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Microcytic and hypochromic red blood cells suggest an underlying disorder.
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What happens to the bone marrow rate of erythropoiesis in response to anemia?
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The presence of __________ red blood cells is indicative of iron deficiency anemia.
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Which RBC indices are reflected in a diagnosis of anaemia?
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A person can have decreased Hb and RBC values but not show any symptoms of anaemia.
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What characterizes a patient as 'clinically anaemic'?
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Match the following RBC indices with their possible diagnoses:
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Study Notes
Anaemia Definition
- Anaemia occurs when the body cannot supply tissues with enough oxygen.
- In the US and Japan, the Hb value is used to indicate anaemia.
- In the UK, the PCV (Hct) value is used to indicate anaemia.
- Anaemia is not a disease, but a symptom of an underlying disorder.
Anaemia Clinical Presentation
- Common signs and symptoms include dizziness, pallor, fatigue, and shortness of breath.
- Laboratory tests often show decreased Hb, RBC Count, and PCV values compared to reference ranges for the patient's age, sex, and population.
Reference Intervals for Anaemia
- Hb Reference Intervals:
- Female: 12-16 g/dL
- Male: 14-18 g/dL
- PCV Reference Intervals:
- Female: 0.37-0.47 L/L
- Male: 0.42-0.52 L/L
- PCV is approximately 3 times the Hb value.
- RBC Count Reference Intervals:
- Female: 4.2-5.4 x 10^12/L
- Male: 4.7-6.1 x 10^12/L
- RBC Indices:
- MCHC (Mean Corpuscular Haemoglobin Concentration): 32-36 g/dL (normochromic)
- MCH (Mean Corpuscular Haemoglobin): 27-31 pg (normocytic)
- MCV (Mean Corpuscular Volume): 80-100 fL (normocytic)
Anaemia Classification
-
Aetiology (Cause):
-
Nutritional Deficiency: Deficiency of Fe2+, Vitamin B12, or Folate.
- Can occur due to dietary lack or malabsorption.
-
Increased RBC destruction: RBCs are destroyed before their normal lifespan of 3 months (Haemolytic Anaemias).
- Example: G6PD Deficiency
-
Decreased RBC Production: Bone marrow produces fewer mature RBCs.
- Can be caused by nutritional deficiencies or ineffective erythropoiesis.
-
Haemorrhage: Loss of RBC mass.
- Acute: Sudden blood loss (e.g., Stab wound), no time for bone marrow compensation.
- Chronic: Gradual blood loss (e.g., GI bleeding), bone marrow attempts to compensate.
-
Nutritional Deficiency: Deficiency of Fe2+, Vitamin B12, or Folate.
- Morphology (RBC appearance): Describes the appearance of RBCs under a microscope.
Aetiological Classification of Anaemia
-
Nutritional Deficiency:
- Dietary lack or malabsorption of Fe2+, Vitamin B12, or Folate.
- Example: Iron Deficiency Anaemia
-
Increased RBC Destruction:
- Haemolytic Anaemias: increased destruction of RBCs before their lifespan.
- Example: G6PD Deficiency
-
Decreased RBC Production:
- Nutritional deficiency or ineffective erythropoiesis.
-
Haemorrhage:
- Acute or Chronic.
Importance of Anaemia Classification
- Different aetiologies require specific treatments.
- Correct classification helps in accurate diagnosis and choosing the ideal treatment.
Morphological Classification of Anaemia
- RBC indices (MCHC, MCH, MCV) are used to describe the appearance of RBCs.
- Hypochromic: MCHC < Reference Interval
- Macrocytic: MCH > Reference Interval, MCV > Reference Interval.
- Microcytic: MCH < Reference Interval, MCV < Reference Interval.
Morphological Classification of Anaemia - Specifics
-
Hypochromic: MCHC < Reference Interval.
- RBCs appear paler than normal due to decreased haemoglobin content.
-
Macrocytic: MCH > Reference Interval, MCV > Reference Interval.
- RBCs are larger than normal.
-
Microcytic: MCH < Reference Interval, MCV < Reference Interval.
- RBCs are smaller than normal.
- Spherocytes/Microspherocytes: MCHC > Reference Interval (RBCs are spherical).
Morphological Classification of Anaemia - Examples
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Hypochromic Microcytic Anaemias:
- Iron Deficiency Anaemia
- Sideroblastic Anaemia
- Thalassemia
- Anaemia of Inflammatory Disorders (chronic Haemorrhage)
-
Normochromic Macrocytic Anaemias:
- Vitamin B12 Deficiency
- Folate Deficiency
- (Others)
-
Normochromic Normocytic Anaemias:
- (Read up and find examples - to be discussed in next class).
Normal Bone Marrow Response to Anaemia
- Bone marrow increases erythropoiesis to compensate for low RBC count.
- Increased bone marrow cellularity and M:E (Myeloid:Erythroid) ratio.
- Increased Reticulocyte Count.
- Signs and symptoms may be delayed or absent even with low Hb, PCV, and RBC counts.
- This means the bone marrow is compensating well.
- When signs and symptoms develop, the bone marrow can no longer fully compensate and the patient becomes clinically anaemic.
Diagnosis of Anaemia - Expected Results
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Decreased Hb, PCV, and RBC Count (from CBC)
- Indicates presence of anaemia.
-
RBC Indices (from CBC): Different patterns suggest different categories:
- Decreased MCHC, MCH, and MCV: Hypochromic, Microcytic Anaemia.
- Increased MCH, MCV, and Normal MCHC: Macrocytic Anaemia.
- Normal MCHC, MCH, and MCV: Normocytic Anaemia.
-
Slide Analysis (Wright's Stain):
- Helps to confirm the appearance of blood cells seen in RBC indices.
- Provides visual assessment of the cells and their appearance, such as morphology and size.
Note about Examples
- Some details are missing that can be added and expanded upon.
- These missing details are intended to be researched and learned by the student for the following class.
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Description
This quiz covers the definition, clinical presentation, and reference intervals for anaemia. Understand the laboratory values and their significance in diagnosing this condition. Test your knowledge on the symptoms, types, and measurements associated with anaemia.
