Prescribing Safety Assessment (PSA) Practice Exam

Which of the following is a cause of normocytic anaemia?

1. Iron deficiency

2. Thalassaemia

3. Acute blood loss (hypovolaemia)

4. Lead poisoning

The correct answer is: Acute blood loss (hypovolaemia)

Normocytic anemia is characterized by red blood cells that are of normal size but present in lower-than-normal quantities. This condition can arise from various causes, each affecting red blood cell production, lifespan, or volume. Acute blood loss, particularly in situations of hypovolemia, leads to normocytic anemia because the overall blood volume is reduced, causing a decrease in circulating red blood cells. Initially, when blood is lost, the body may still produce red blood cells that are normocytic, as the marrow is often still functioning adequately and responding to erythropoietin. Over time, if the blood loss is not compensated, or if there are insufficient reserves, anemia can become more pronounced. In contrast, the other choices are associated with different types of anemia. For instance, iron deficiency anemia typically presents with microcytic red blood cells due to inadequate iron for hemoglobin production. Thalassemia is a genetic disorder that causes microcytic anemia due to abnormal hemoglobin. Lead poisoning can also lead to microcytic anemia, primarily because of its interference with hemoglobin synthesis. Therefore, acute blood loss is the primary cause leading to normocytic anemia, as the immediate effect on red blood cell mass and the body’s