HMM204 Quiz: Haematology & Immunology

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Questions and Answers

What is the primary basis for classifying anaemia?

Frequency of symptoms

Level of haemoglobin

Degree of fatigue

Size of the red blood cells (correct)

What is a common manifestation of anaemia?

Pallor and shortness of breath (correct)

Improved concentration

Weight gain

Increased appetite

What is a possible cause of anaemia?

High haemoglobin levels

Infection

Adequate nutrition

Deficient production of red blood cells (correct)

What is a treatment principle for anaemia?

Addressing underlying causes Signup and view all the answers

What is a characteristic of macrocytic anaemia?

Large red blood cells Signup and view all the answers

What is a diagnostic indicator of anaemia?

Reduced red cell indices and haemoglobin levels Signup and view all the answers

What is the primary mechanism underlying anaemia of chronic disease?

Reduced iron absorption due to increased hepcidin Signup and view all the answers

Which of the following is a characteristic of megaloblastic anaemia?

Macrocytic normochromic erythrocytes Signup and view all the answers

What is the primary cause of microcytic anaemia?

Iron deficiency Signup and view all the answers

What is the consequence of B12 and folate deficiency in megaloblastic anaemia?

Asynchrony in nuclear/cytoplasmic maturation in bone marrow Signup and view all the answers

What is the result of excess normal chain in thalassaemia?

Ineffective erythropoiesis and often haemolysis Signup and view all the answers

Which of the following is a cause of B12 deficiency?

All of the above Signup and view all the answers

What is the effect of hepcidin on iron metabolism?

Decreases iron absorption Signup and view all the answers

What is the diagnosis of thalassaemia based on?

All of the above Signup and view all the answers

What is the manifestation of B12 deficiency in the nervous system?

All of the above Signup and view all the answers

What is the clinical manifestation of iron deficiency anaemia?

Fatigue, pallour, and exertional dyspnoea Signup and view all the answers

What is the characteristic of the red blood cells in megaloblastic anaemia?

Macrocytic normochromic erythrocytes Signup and view all the answers

What is the principle of iron deficiency diagnosis?

Soluble transferrin receptor is inversely proportional to iron stores Signup and view all the answers

What is the effect of anaemia of chronic disease on erythropoiesis?

Decreased erythropoiesis Signup and view all the answers

What is the consequence of alpha thalassaemia major?

Intrauterine death Signup and view all the answers

What is the laboratory feature of megaloblastic anaemia?

Reduced serum B12 and RBC folate Signup and view all the answers

What is the primary cause of haemolysis in microcytic anaemia?

Defective haemoglobin Signup and view all the answers

What is the inheritance pattern of alpha thalassaemia?

Deletion of one or more of the 4 alpha globin genes Signup and view all the answers

What is the underlying mechanism of anaemia of chronic disease?

Reduced iron availability due to inflammation Signup and view all the answers

What is the clinical manifestation of iron deficiency in infancy?

Rapid growth and increased demand Signup and view all the answers

What is the primary cause of anaemia of chronic disease?

Chronic inflammation Signup and view all the answers

Study Notes

Anaemia

Definition: An abnormally low number of circulating red blood cells or level of haemoglobin (or both)
Causes: Deficient production, Excessive loss or destruction, Defective function
Manifestations:
- Reduction in red cell indices and haemoglobin levels
- Impaired oxygen transport with resulting compensatory mechanisms
- Weakness or fatigue, general malaise, and sometimes poor concentration
- More severe anaemia leads to:
  - Paleness (pallor)
  - Shortness of breath (dyspnoea) on exertion

Classification of Anaemia

Most common classification is based on RBC size:
- Microcytic anaemias (reduced MCV)
- Normocytic anaemias (normal MCV)
- Macrocytic anaemias (increased MCV)

Primary Anaemias

Microcytic anaemias:
- Causes: Iron deficiency, Globin defects, Anaemia of chronic disease, Exposures (lead / alcohol / drugs), Hereditary causes
- Example: Iron deficiency
  - Causes: Decreased intake, Decreased dietary iron, Malabsorption, Increased demand, Excessive blood loss
  - Clinical features: Anaemia, fatigue, pallour, exertional dyspnoea, Spoon-shaped nails (koilonychia), Swollen tongue (glossitis)
- Example: Thalassaemia
  - Failure to synthesise α or β globin chains
  - Results in imbalance in globin chain production, Defective haemoglobinisation, Excess normal chain – ineffective erythropoiesis (and often haemolysis)
- Alpha thalassaemias:
  - Gene deletion of one or more of the 4 α globin genes
  - Clinical syndromes relate to number of genes deleted
  - Examples: Thalassaemia minor, Haemoglobin H disease, Barts disease

Secondary Anaemias

Haemolytic anaemias:
- Reduced red blood cell life span
- Defective haemoglobin – loss of functionality
- Excessive breakdown/loss – Haemolysis – Blood loss
Macrocytic anaemias:
- Causes: Megaloblastic anaemias (B12 and folate deficiency), Myelodysplasia and other bone marrow disorders, Recovery from blood damage/loss, Alcohol abuse/liver disease, Medications – impair DNA synthesis
- Example: B12 and folate deficiency – megaloblastic anaemia
  - Causes: Dietary, Malabsorption, Pernicious anaemia, Achlorhydria, Gastrectomy, Coeliac disease, Surgical, Nitrous oxides, Congenital deficiencies
  - Consequences: Megaloblastic RBCs, Sore ‘beefy’ red tongue (glossitis), Anorexia, weight loss, diarrhoea, B12 deficiency only Neurological features, Peripheral neuropathy, Degeneration of spinal cord, Confusion / dementia

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Description

This quiz covers the signs and symptoms of anaemia, including primary microcytic anaemias, normocytic anaemias, and macrocytic anaemias. It is based on Chapter 8, 10-17 of HaaG and is part of the Deakin Medical School's Haematology & Immunology course.