Haematology (Anaemia): Past Paper PDF

**[HAEMATOLOGY]** **[ANAEMIA]** - **Low** **HB** due to *[decreased]* **Red Cell Mass** - **NORMAL RANGE** **110-180G/L** **Female** (**130-180** male) -- more in **Men** **[Normal FBC Appearance]** **Neutrophils** **Red cells** **Platelets** **[IRON DEFICIENCY...

**[HAEMATOLOGY]** **[ANAEMIA]** - **Low** **HB** due to *[decreased]* **Red Cell Mass** - **NORMAL RANGE** **110-180G/L** **Female** (**130-180** male) -- more in **Men** **[Normal FBC Appearance]** **Neutrophils** **Red cells** **Platelets** **[IRON DEFICIENCY ANAEMIA]** - **It Is -- Pale Celled -- Small Celled - HYPOCHROMIC** **MICROCYTIC ANAEMIA** - **Low** **Hb** and **Low** **MCV** with **Low** **Ferritin levels** **[FBC - Normal values]** - **[HAEMOGLOBIN]** **Male** **130-180g/l** **Female** **110-180g/l** - **Haematocrit** **0.35-0.50** - **MCV** **77-87 fl** - **MCH** **25-33 pg** - **White Cell Count** **4.5-10 x 10⁹/l** - **Platelets** **150-400 x 10⁹/l** **[Terminology]** - **TOO MANY** = **Cytosis** - **NOT ENOUGH** = **Paenia** - **EXAMPLE**: **Platelets**, too many = **Thrombocytosis** - **NOT ENOUGH** = **Thrombopaenia** **[Main Types of Anaemia]** - **Microcytic Hypochromic - Iron Deficiency** - **NORMOCYTIC** - **Anaemia** of **Chronic Disease** (**RA**, **Chronic Kidney Disease**) - **MACROCYTIC** - **B₁₂, Folate DEFICIENCY** **[Possible Causes of IRON DEFICIENCY - Need to find an Explanation in an EXAM ]** - **Dietary** **Deficiency** - **Malabsorption -- Iron** *[not being]* **Absorbed** - **Blood Loss** (**Chronic**) - **GI Tract** - **Menorrhagia** **[B12 and Folate Deficiency - Lead to Macrocytic Anaemia]** - **4 months' supply** of **Folate** in the **Body** - *[found]* in **Leafy Vegetables**, **Liver**, and **Fruit** - *[Absorbed]* in **Small Intestine --** *[People]* with **Crohn's** will be deficient *[sometimes]* - 2-6 years' *[supply]* of **B12** in **Body**, *[found]* in **Animal Protein** - *[Needs]* **Intrinsic Factor** for *[absorption]* in **Terminal Ileum** **[Folate Deficiency - Causes]** - *[Reduced]* **Intake** e.g. elderly - **Alcoholism** - *[Increased]* **Requirements** e.g. **Pregnancy**, **Haemolysis** - **Malabsorption** e.g. **Coeliac Disease** - **Drugs** e.g. **Methotrexate (***[should also be taken addition]* **Folic Acid)** **[B12 Deficiency - Aetiology]** - **Inadequate** **Intake** - *[Low]* **Gastric Acid** (10-30% patients with Partial **Gastrectomy**) - **INTRINSIC FACTOR/ANTIBODIES** *[against]* **Parietal Cells** (**PERNICIOUS ANAEMIA**) - **ABNORMAL ABSORPTION** in **TERMINAL ILEUM -- *[IF THEY HAVE ONE]* AI CONDITION, *[THEY MAY HAVE MORE]*** **[Pernicious Anaemia ]** - **Malabsorption** of **vitamin B₁₂** *[due]* to **decreased** **Intrinsic Factor** - **Associations** - **THYROID**, **VITILIGO (Autoimmune Problem)** , **ADDISON'S (autoinnue)** - **Hb** **decreased (Macrocytic)** **[Diagnosis of B12 and Folate Deficiency]** - **Red Cell Folate Levels** - **Serum Vit B12 Levels \-\-\-\--** **Intrinsic Factor Antibodies** **[TREATMENT]** - *[identify]* **Underlying Cause**, **Oral Folate Replacement** or **Lifelong Injections** of **Vitamin B12** *[every]* **3 months** - *[Any question]* about **BLEEDING**, *[you wll end up]* **Always** **Talking** *[about]* **ANEMIA** etc **[Other Potential Causes of Macrocytic Anaemia]** - **Drug** **Related** e.g. **Methotrexate** - **Alcohol** - **MYELODYSPLASIA --** *[Reffer to the]* **Bone Marrow** *[and the]* **Function** of **Producing** **Blood Cells** **['Blood' Transfusions] -- [Plasma *are sperate from* Red Blood Cells ]** - **Avoid** if *[possible]* -- **Cross Infection** [ ] - **70 G/L or SYMPTOMATIC** - *[Matched]* to **Patient's** *[own]* **BLOOD GROUP** - **RHESUS** **NEGATIVE** is the '**Universal Donor'** - **AB POSITIVE** is the '**Universal Recipient'** **[White Cell Count]** - **Normal** = **4.5-10 x 10⁹/l** **[Neutrophils - Bacterial]** - **Increase in number** - **Bacterial Infection**, **Trauma**, **Surgery** - **Decrease** - **Viral Infections**, **Some Drugs** *[Used to determine if the issue]* of **Viral** or **Bacterial** **[Lymphocytes]** - **Increase** - **Viral Infections**, CLL - **Decrease** - **Steroid Treatment**, SLE **[Eosinophils]** - **Increase** *[seen in some]* **Allergic Disorders** **[PLATELET ABNORMALITIES]** - **NORMAL PLATELET COUNT** **150-400 x 10⁹/l** - **Numbers** (**Thrombocytopaenia**) **\