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Anaemia (High MCV (Investigations (B12 /folate, LFTs, TFTs, reticulocytes,…

- - - - Mechanical
        
        DIC
        
        HUS
      - Infective
        
        Malaria
      - Immune mediated
        
        Auto immune
        
        +ve indirect coombe test
        
        Drugs
    - - Enzyme defect
        
        Glucose 6 Phosphate Dehydrogenase (G6PD ) deficiency
      - Membrane defect
        
        Hereditary shperocytosics
- - - - Poor use iron in erythropoiesis
      - Cytokine induced shortening of RBC life
      - \/ response and production of erythopoieten
    - - Treat underlying disease
      - Erythropoieten
- - - - Causes
        
        Blood loss
        
        Poor Diet
        
        Malabsorption
        
        Hookworm
      - Treatment
        
        ferrous sulphate 200mg 3d
        
        IV iron only if oral fails
        
        Blood transfusion
    - - Aetiology
        
        Genetic condition
        
        Under production of globin chains
        
        Usually beta chain of chromosome 11
        
        minor, intermedia and major disease
      - Tx (beta major)
        
        life long transfusions ~2-4 weeks
        
        Folate supplements
        
        Iron chelators
        
        ascorbic acid
        
        Splenectomy
        
        Histocompatible bone marrow transplant can be a sure
      - Complications
        
        bossing of skull
        
        hepatosplenomegaly
        
        Iron overload (due to Tx)
        
        endocrine failure (due to high iron)
        
        Organ damage (due to high iron)