Normocytic And Macrocytic Anemia MCQs

A bone marrow cellularity of Reference: Wintrobes 13/p 1189

FANCONI ANEMIA IS INHERITED BONE MARROW FAILURE SYNDROME CAUSING APLASTIC ANEMIA Reference: Robbins & Cotran Pathologic Basis of Diseases 10 th edition, chapter 13, pg 622

MCV - 101fl is suggestive of macrocytosis Most commonly (especially when the increase in size is mild, and just above normal range) the cause is bone marrow dysplasia secondary to alcohol abuse and chronic alcoholism, Poor absorption of vitamin B12 in the digestive tract can also cause macrocytosis. Macrocytosis is frequently linked to alcoholism, with or without liver disease. In fact, it is purported to be one of the most common causes of non megaloblastic macrocytosis. In cases of macrocytosis related to alcoholism the elevated MCV may be due to the direct effect of the alcohol, liver disease and/or folate deficiency. Reference: Robbins & Cotran Pathologic Basis of Diseases 10 th edition Chapter 18, pg 841

Explanation: Macrocytic anaemia in liver disease arises due to: Altered lipid metabolism: Excess cholesterol deposition on RBC membranes increases their surface area, leading to macrocytosis. Nutritional deficiencies: Liver disease is associated with vitamin B12 and folate deficiency, impairing DNA synthesis and causing megaloblastic anaemia. Bone marrow suppression: Chronic liver dysfunction can affect erythropoiesis, contributing to macrocytosis. Explanation of other options: Thalassemia (Option A): Associated with microcytic anaemia due to defective haemoglobin synthesis; MCV is decreased. Anaemia of Chronic Disease (Option B): Typically, normocytic or microcytic due to inflammation-mediated iron dysregulation; MCV is normal or low. Sideroblastic Anaemia (Option C): Usually microcytic due to defective heme incorporation into globin chains; MCV is low or normal.

A special form of red cell aplasia occurs in individuals infected with parvovirus B19, which preferentially infects and destroys red cell progenitors. Normal individuals clear parvovirus infections within 1 to 2 weeks; as a result, the aplasia is transient and clinically unimportant. However, in persons with moderate to severe hemolytic anemias, even a brief cessation of erythropoiesis results in rapid worsening of the anemia, producing an aplastic crisis. Reference: Robbins 9th ed p 655

Megaloblastic anemia has a low normal Retic % as it is a nutritional anemia. Reference: Robbins & cotran pathologic basis of diseases, 10 th edition Chapter 14, pg 651

Shwachman-Diamond syndrome (SDS) is an autosomal recessive disorder characterized by exocrine pancreatic insufficiency and persistent or intermittent neutropenia and an increased susceptibility to infections. Hematologic problems also can include anemia, thrombocytopenia, and pancytopenia. Reference: Wintrobes 13/p 1523-1533