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Anaemia - Coggle Diagram

- - - - Leg ulcers
      - ↑ output heart failure
      - Chronic tissue hypoxia
      - Hypermetabolic state → nutritional deficiencies, growth impairment
    - - Liver
      - Pancreas or other endocrine glands
      - Kidneys
      - Myocardium
      - Hormone
  - - - Dark urine
      - Hepatosplenomegaly
      - Jaundice
    - - Wide or brittle one
      - Facial bone deformities
      - ↓ growth and ↓ puberty
    - - Systemic: pallor, fatigue, activity intolerance
      - Cardiac: altered haemodynamics (tachycardia, ↓ blood pressure, arrythmias, palpitations)
  - - - Mediterranean, Middle Eastern, Southeast Asian, & African genetic descents
      - Inherited haemoglobinopathies
    - - Hb is made up of 2 proteins
        
        Alpha Globin
        
        Beta Globin
  - - - Excess unpaired alpha or beta globin chains aggregate
        
        Forms a precipitate, that damages RBC membranes
        
        Intravascular hemolysis
  - - - Gene related to Alpha globin protein are missing/changed (mutated)
        
        Alpha globin chains are absent/reduced
        
        Alpha thalassaemia
    - - Similar gene defects affect the production of beta globin protein
        
        Beta globin chains are absent/reduced
        
        Beta thalassaemia = Cooley anaemia
    - - Homozygote → thalassaemia major → life threatening anaemia
      - Homozygous person → 2 thalassaemic genes → thalassaemia major = severe conditions
      - Inherited defected gene from both parents
    - - Inherited faulty gene from one parent
      - Heterozygote → thalassaemia minor = thalassaemia trait (carrier)
      - Heterozygous person has 1 thalassaemic gene & 1 normal gene → thalassaemia minor (thalassaemia trait) = mild form of disease
- - - - ↓ Absorption
        
        Celiac disease
        
        Surgical resection of GIT
        
        Bariatric surgery
    - - ↑ Need
        
        Pregnancy
        
        Lactation
      - ↑ Growth
        
        Infants and children
        
        Adolescents
    - - ↓ Intake
        
        Self-imposed dietary restrictions
        
        Food insecurity
        
        Eating disorder
    - - Over blood loss
      - Occult
        
        Vascular lesions
        
        Helminth infections
        
        GIT bleed
  - - - Fatigue, activity intolerance, dyspnoea
      - Compensatory mechanism
      - Pallor
    - - Cheilosis (cracking, crusting, and scaling of the mouth)
      - Koilonychia (spoon-shaped, concave nails)
      - Glossitis (smooth "beefy red" tongue)
      - Oesophageal structure
  - - - ↓ Fe for Hb synthesis
        
        Impaired erythropoiesis
        
        ↓ Hb → insufficient O2 delivery to body tissues
- - - - Drugs
      - Viruses
      - Immune process
      - Toxic chemicals
      - Ionising radiation
    - - Insidious onset of BM hypoplasia/aplasia → haematopoietic cell loss → ↓ production of cell (thrombocytes, leukocytes, erythrocytes) → peripheral pancytopaenia
    - - Familial aplastic anaemia
      - Shwachman-Diamond Syndrome
  - - - Mucosal haemorrhage
      - Bleeding from gastrointestinal tract & brain = serious
    - - Pallor, fatigue, dyspnoea, activity intolerance, cardio-respiratory compromised
    - - ↑ severity/frequency of infections
      - Neutropaenia (related sepsis is common cause of death)
    - - Shorter lifespan
  - - - Damaged stem cells not able to produce blood cells properly
        
        BM aplasia (empty) or hypoplasia (inadequate)
        
        Pancytopaenia (insufficient numbers of RBCs, white blood cells [WBCs] and platelets)
- - - - Alcoholism
      - Metabolic interference from medications
      - Malabsorption
      - Adequate diet but ↑ requirements
      - Insufficient diet
    - - ↓ diet
      - Malabsorption
        
        Pancreatic ↓ → impaired binding of B12 to intrinsic factors → pernicious anaemia
        
        Surgery → gastrectomy, bariatric → lack of absorptive
        surface → pernicious anaemia
        
        ↓ intrinsic factors (stomach protein) → pernicious
        anaemia
        
        Medications that interferes absorption
  - - - Jaundice
      - Splenomegaly
    - - Numbness
      - Tingling
      - Weakness
    - - Activity intolerance
      - Pallor
      - Fatigue
      - Compensatory mechanism
  - - - BM changes
        
        Abnormally large erythrocytes produced = megaloblast (cannot get out of BM to move into bloodstream)