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Anemia introduction - medicaldump.com

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  • 1. Anemia - Introduction
  • 2. Normal ErythropoiesisKidney Bone marrow Multi-potent stem cell Epo mRNA Erythroid stem cell Epo Oxygen sensor 3-4 days Blood vessel Peripheral blood RBC survival 100-120 days
  • 3. Anemia• Understanding anemia – Disease - to be treated on its own merits – Condition - a secondary manifestation of another disease – Symptoms depend on severity/acuity• Causes – Decreased production – Blood loss – Hemolysis
  • 4. Laboratory Evaluation of Anemia• Complete blood count• Peripheral smear• Reticulocyte count – Relative reticulocyte count ♦ Percent of all RBC (normal 0.8%–1.5%) – Absolute reticulocyte count ♦ Relative reticulocyte count x RBC count ♦ Normal 50,000–75,000/µl ♦ Examples: 6 1.1% x 4.96 x10 = 55,000/l 6 12.2% x 2.05 x10 = 250,000/l
  • 5. Classification of Anemia Based on RBC Kinetics and Size MCV Microcytic Normocytic MacrocyticRetic Low Common Common Commoncount High Uncommon Common Uncommon
  • 6. Microcytic Hypochromic Anemia: Diagnosis• Mild (MCV > 70 fl) • Severe (MCV < 70 ) – Iron deficiency – Iron deficiency – Thalassemia – Thalassemia – Lead toxicity – Sideroblastic anemia – Anemia of chronic disease
  • 7. Macrocytic Anemia with Low Reticulocyte Count• Megaloblastic anemia – Vitamin B12 deficiency – Folate deficiency• Non-megaloblastic macrocytic anemia – Liver disease – Hypothyroidism – Drug-induced (DNA synthesis block) – Myelodysplastic syndrome