26 Questions
What is the primary basis for classifying anaemia?
Size of the red blood cells
What is a common manifestation of anaemia?
Pallor and shortness of breath
What is a possible cause of anaemia?
Deficient production of red blood cells
What is a treatment principle for anaemia?
Addressing underlying causes
What is a characteristic of macrocytic anaemia?
Large red blood cells
What is a diagnostic indicator of anaemia?
Reduced red cell indices and haemoglobin levels
What is the primary mechanism underlying anaemia of chronic disease?
Reduced iron absorption due to increased hepcidin
Which of the following is a characteristic of megaloblastic anaemia?
Macrocytic normochromic erythrocytes
What is the primary cause of microcytic anaemia?
Iron deficiency
What is the consequence of B12 and folate deficiency in megaloblastic anaemia?
Asynchrony in nuclear/cytoplasmic maturation in bone marrow
What is the result of excess normal chain in thalassaemia?
Ineffective erythropoiesis and often haemolysis
Which of the following is a cause of B12 deficiency?
All of the above
What is the effect of hepcidin on iron metabolism?
Decreases iron absorption
What is the diagnosis of thalassaemia based on?
All of the above
What is the manifestation of B12 deficiency in the nervous system?
All of the above
What is the clinical manifestation of iron deficiency anaemia?
Fatigue, pallour, and exertional dyspnoea
What is the characteristic of the red blood cells in megaloblastic anaemia?
Macrocytic normochromic erythrocytes
What is the principle of iron deficiency diagnosis?
Soluble transferrin receptor is inversely proportional to iron stores
What is the effect of anaemia of chronic disease on erythropoiesis?
Decreased erythropoiesis
What is the consequence of alpha thalassaemia major?
Intrauterine death
What is the laboratory feature of megaloblastic anaemia?
Reduced serum B12 and RBC folate
What is the primary cause of haemolysis in microcytic anaemia?
Defective haemoglobin
What is the inheritance pattern of alpha thalassaemia?
Deletion of one or more of the 4 alpha globin genes
What is the underlying mechanism of anaemia of chronic disease?
Reduced iron availability due to inflammation
What is the clinical manifestation of iron deficiency in infancy?
Rapid growth and increased demand
What is the primary cause of anaemia of chronic disease?
Chronic inflammation
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
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.
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