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Diagnostic approach towards anemia
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Diagnostic approach towards anemia

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Diagnostic approach towards anemia Diagnostic approach towards anemia Presentation Transcript

  • Diagnostic approach towards Anaemia By: Dr Farhan Khanzada
    • Anaemia.
    • Reduction in Haemoglobin concentration.
    • Less than 13.5g/dl in male adult
    • Less than 12.0g/dl in female adult
    • New born less than 14.0g/dl (physiological)
  • DIAGNOSTIC APPROACH
    • Clinical
    • Laboratory
  • Clinical Approach
    • The Clinical approach towards anaemia comprises of
    • 1-History 2-Physical examination
  • Importance of History
    • The History taking is of great importance in diagnosing an anaemia as many laboratory features specific of anaemia can be secondarily due to other systemic diseases like connective tissue disorders.
  • Common presenting complaints
    • Weight loss
    • Fever
    • Weakness (localized or generalized)
    • Fatigue, malaise, lassitude
    • Palpitation
    • Headache
    • Blurring of vision
    • Dyspnoea on exertion
  • Systemic Inquiry
    • Nervous system
    • Ask about
    • Headache (severe anaemia)
    • Paraesthesia (pernicious anaemia)
    • Confusion (severe anaemia)
    • Eyes (vision)
    • Ears
    • Nasopharynx, Oropharynx, Oral Cavity
    • Ask about:
    • Anosmia
    • Olfactory Hallucinations
    • Sore tongue
    • Dysphagia
  • Chest and Heart
    • Ask About:
    • Dyspnoea
    • Palpitations
  • GIT, Genitourinary System
    • Ask about
    • Diarrhoea
    • Constipation
    • Upper GIT bleeding
    • Melina
    • Menorrhagia
    • Hematuria
  • Trunk, Extremities, Skin
    • Ask about
    • Backache ( acute haemolytic process )
    • Right shoulder pain
    • Leg ulcers
    • Cyanosis
  • Nutrition
    • Ask about:
    • Breastfeed ( iron deficient )
    • Other nutritional deficiencies
    • Uncooked fish intake( fish tapeworm infestation)
  • Family History
    • Importance in:
    • Hereditary Spherocytosis ( dominant inheritance)
    • Ethnic background importance in thalassemia, sickle anaemia, G6PD deficiency anemia.
  • Miscellaneous
    • Ask about:
    • Drugs
    • Chemicals
    • Herbal medicines.
  • Physical Examination
    • Examining a suspected case of anaemia, the followings should be considered with care.
    • Pallor
    • Cyanosis
    • Jaundice
    • Petechiae, ecchymoses
    • Leg ulcers
    • Eyes
    • Mouth
    • Nails
    • Joints
  • LABORATORY APPROACH
  • Examination of Blood
    • We examine blood to answer these two questions.
    • Is marrow producing sufficient numbers of mature cells in major haematopoitic lineages?
    • Is the development of each haematopoitic lineage qualitatively normal?
  • Quantitative Examination
    • Automated cell counter
    • (Principal)
    • RBC count x 10*12/L(4.5-6.5)(3.9-5.6)
    • Haematocrit
    • [RBC (x 10 -6 /µl)x MCV(fl)/10]
    • Microhaematocrit
    • Haemoglobin (g/dl)
    • (14.0 – 16.5) males.
    • (12.5 – 15.5) Females.
    • Estimation Of Haemoglobin by Prick Method.
    • (Principle and Method )
    • MCV (80 – 100)fl.
    • Classification of anaemia.
    • Retics count(0.5-1.5%).
    • RDW.
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  • Peripheral blood pictures
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    • THANKS!…..