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pernicious anaemia
paenicious anaemia
25
Medical
Graduate
05/21/2009

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Cards

Term
general causes of anaemia
Definition
decreased production, increased destruction, increased loss
Term
symptoms of anaemia
Definition
pallor, fatigue, dypnoea on exertion. faintness, angina, palpiations, claudication
Term
signs of anaemia
Definition
pallor, tachycardia, murmur, cardiac failure
Term
approach to anaemia
Definition
History - classical symptoms. diet, family history, drug use, obstetric and gynae history, GIT history, infection, malignancy. Examination - pallor, BP and pulse, jaundice, purpura, glossitis, stomatitis, flow murmurs, splenomegaly
Term
blood investigations
Definition
Hb and Hct RDW. rectiulocyte count (raised blood loss and haemolytic), MCV, WBC, platelets (raised in bleeding). the blood film
Term
bone marrow investigation
Definition
aspirate - cell morphology. Trephine - architecture of marrow, cellularity, infiltrates
Term
iron defeciency anaemia
Definition
typically microcytic hypochromic. causes - blood lossses, decreased intake, increased deman. Clinical features - koilynychias, atrophy of pappillae, brittle hair
Term
blood results of iron defecient anaemia
Definition
low serum iron, low ferritin, increased transferrin. microcytic, hypochromic cells with anisocytois (increased RDW) and poikilocytosis
Term
thalassaemia
Definition
anaemia, splenomegaly, extramedullary haemopoisis, chip munk face, mediteranian or african origon, haemosiderosis
Term
anaemia of chronic disease
Definition
chronic inflammatory conditions - DM, RA, SLE, TB, Malignancy. Release of inflammmatory mediators causes a decrease in the absorption of iron and decreased export from iron stores
Term
blood results of anaemia of chonic disease
Definition
low serum iron and transferrin, raised ferritin levels. measure CRP
Term
types of blood products
Definition
packed red blood cells. platelets. fresh frozen plasma
Term
compatability testing for transfusion
Definition
blood group ABO Rh, antibodies screen, direct cross match
Term
when to transfuse
Definition
treatment of hypoxia. Hb <70g/L or Hb < 100g/L if showing signs of hypoxia
Term
Types of transmusion reactions
Definition
common - febrile, allergic, haemolytic, circulatory overload, hypothermia. Rare - TRALI, infection, hypotensive reactions, GVHD
Term
haemolytic tranfusion reactions
Definition
Intravascular - immediate, anti-A anti B. features - restless, vomiting, diarrhoea, chills, chest pain, circulatory collapse, haemoglobinaemis, haemoglobinuria
Term
key regulation of RBC production
Definition
key trigger for RBC production in hypoxia. hypoxia in kidney tubules increases production of erythropoietan that causes an increase in proliferation of erythroid precursor cells
Term
function of the RBC
Definition
transport of oxygen, carbon dioxide, acid base buffer
Term
Features of the RBC
Definition
biconcave disc, deformable, carry upto 34g/dl of Hb, average level is 14g/dl, cell live is 120 days, size 8 microns
Term
different sites of haematopoesis
Definition
embryo - in the yolk sac. In Utero - firstly in liver and spleen, seeding of marrow occurs at 8 weeks at 8 months marrow is major sigh. by six months post gestation the marrow is exclusive sight. Infancy - all bones are haemopoetic active. Adult - axial skeleton
Term
absorption and transport of iron
Definition
absorbed by the enterocyte via pinocytosis (heme) or DMT1 and stored in labile pool. absorption into the blood stream occurrs via IREG-1 with help of haemphastin or ceruloplamin and binds to transferrin receptors to be transported to cells that uptake via expression of transferrin receptors
Term
regulation of iron stores
Definition
regulated on the absorption side. 1. TF saturation then has no way of uptaking iron from enterocyte. HFE - binds to transferrin decreasing it abilty to bind and release iron. Hepcidin - produced by liver and causes the internalisiation of IREG-1 on the enterocyte
Term
patients explanatary model of health
Definition
the patients understanding of the cause, severity, prognosis, expected treatment and the effect it will have on there life
Term
influence of explanatory model
Definition
cultural, SES, psychological, education, family, social, life experiences
Term
explore the explanatory model
Definition
what do you think caused this, how does this effect your life, what worries you the most, what sort of treatment would you prefer
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