This document discusses anemia, including its definition, mechanisms, diagnosis, and symptoms. It provides normal hemoglobin and red blood cell count ranges. Diagnosing anemia involves taking a thorough history including diet, medications, surgery, menstruation, smoking, drinking, and family history. A physical exam evaluates the conjunctiva, cardiovascular system, liver, and spleen for signs of paleness or bleeding. Common symptoms of anemia include fatigue, rapid heartbeat, shortness of breath, difficulty concentrating, brittle nails and hair, and pale skin.

1. Definition:
Reduced Hemoglobin concentration in
blood lower than the normal level,
relative to the age, sex, race, and
physiological status.

2. The importance of history taking
and
clinical examination in
diagnosing anemia

3. Normal range for Hb and
RBC
Hb (g/L)
Males :
RBC
(10^12/L)
120 – 160g/L 4.0-5.5
Females:
110 – 150
3.5 – 5.5
Neonates:
170 – 200
6.0 - 7.0

4. General Mechanisms
1.RBC loss without RBC destruction
2.Deficient RBC production: Bone Marrow
Failure
3.Increased RBC over destruction :
Hemolysis

5. History taking:
It is the process of gathering
information from the patient.
Ask the patients address?
Age?
What type of work the patient does?
Previous illnesses?
The presenting complaint?

6. Diagnosis of Anemia
Diet : Tea/ coffee intake? Chelating agents.
Vegetarian or lack of leafy greens?
Intake of folic acid effect growth rate
Iron intake effects hemoglobin levels.
Pregnant? Dividing nutrients between two
people.

7. Surgical history :
What surgeries have been performed? Surgeries
cause lots of blood loss. Surgery cutting the
ileum.
Glucose 6 Phosphate Dehydrogenase deficiency
occurs after surgeries. Essential in RBC
metabolism.

8. Blood :
Menstruation, chronic bleeding, blood
donation, concealed bleeding – hemorrhage
can cause more iron deficiency

9. Drug History:
NSAIDS ex: Aspirin, Corticosteroids, Warfarin
Family History :
Hemolytic anemia, Pernicious anemia, Sickle cell
disease.
Social History :
Alcohol intake?
Smoker? Both increase the stomach acidity which
can irritate a peptic ulcers which cause internal
bleeding.

10. Physical Examination
Evaluate conjunctiva and mucous membranes for
paleness
Cardiovascular system for murmur
Liver
Spleen
Look for jaundice or purpura

13. Symptoms
Easy fatigue and loss of energy
Rapid heart beat,
Shortness of breath and headache
Difficulty concentrating

14. Brittle nails
Koilonychia (spoon shaped nails)
Angular stomatitis
Brittle hair
Glossitis, Atrophy of paillae of the tongue

15. Dizziness
Pale skin
Leg cramps

16. Special thanks to
Dr. K. D. Mahinda