1. Anaemia is caused by a reduction in red blood cells, haemoglobin, and hematocrit due to decreased red blood cell production, increased destruction, or blood loss. 2. Anaemia can be classified morphologically based on red blood cell size (MCV) and colour (MCHC) as normocytic normochromic, macrocytic normochromic, macrocytic hypochromic, or microcytic hypochromic. 3. Hemorrhagic anaemia results from blood loss and can be acute, from a sudden large loss, or chronic, from internal or external bleeding over a long period.

1. ANAEMIA
DR. IFRA
ASSISTANT PROFESSOR
COLUMBIAGROUP OF INSTITUTIONS

5. • Reduction in RBC count, haemoglobin content and
PCV occurs because of:
1. Decreased production of RBC .
2. Increased destruction of RBC .
3. Excess loss of blood from the body.

8. „MORPHOLOGICAL CLASSIFICATION
1. Normocytic Normochromic Anaemia Size (MCV)
and colour (MCHC) of RBCs are normal. But the
number of RBC is less.
2. Macrocytic Normochromic Anaemia RBCs are larger
in size with normal colour. RBC count is less.
3. Macrocytic Hypochromic Anaemia RBCs are larger
in size. MCHC is less, so the cells are pale (less
coloured).
4. Microcytic Hypochromic Anaemia RBCs are smaller
in size with less colour

13. • Hemorrhage refers to excessive loss of blood. Anemia due to
hemorrhage is known as hemorrhagic anemia
TYPES
1. Acute.
2. Chronic.
ACUTE HAEMORRHAGE
• Acute hemorrhage refers to sudden loss of a large quantity of
blood as in the case of accident. Within about 24 hours after
the hemorrhage, the plasma portion of blood is replaced.
• The replacement of RBCs does not occur quickly and it takes
at least 4 to 6 weeks.
• RBCs are normocytic and normochromic.

14. Chronic hemorrhage
• It refers to loss of blood by internal or external bleeding, over
a long period of time.
• It occurs in conditions like peptic ulcer,, haemophilia and
menorrhagia.
• This affects the synthesis of hemoglobin resulting in less
hemoglobin content in the cells.
• The cells become small. Hence, the RBCs are microcytic and
hypochromic

16.  Haemolytic anemia is a condition in which red blood cells are
destroyed and removed from the blood stream before their
normal lifespan is over.
 It results due to increase in the rate of red cell destruction.
CLASSIFICATION
 Extrinsic hemolytic anemia.
 Intrinsic hemolytic anemia.

17. Extrinsic hemolytic anemia
It is the type of anemia caused by destruction of
RBCs by external factors.
Healthy RBCs are haemolysed by factors outside the
blood cells such as antibodies, chemicals and drugs.
Extrinsic hemolytic anemia is also called autoimmune
hemolytic anemia.

18. Causes of external hemolytic anemia:
a. Liver failure
b. Renal disorder
c. Hypersplenism
d. Burns
e. Drugs such as penicillin, antimalarial drugs and sulfa drugs
MORPHOLOGY OF RBC
 Normocytic Normochromic

19. Intrinsic hemolytic anemia
 It is the type of anemia caused by destruction
of RBCs because of the defective RBCs.
There is production of unhealthy RBCs
 Intrinsic hemolytic anemia is often inherited
and it includes sickle cell anemia and
thalassemia

23. • Sickle cell anemia is an inherited blood disorder,
characterized by sickle shaped red blood cells.
• It is also called hemoglobin SS disease or sickle cell
disease.
• Sickle cell anemia is due to the abnormal hemoglobin
called hemoglobin S (sickle cell hemoglobin). In this,
αchains are normal and βchains are abnormal.
• Sickle cell anemia occurs when a person inherits two
abnormal genes.

28. α-Thalassemia
• It occurs in fetal life or infancy.
• α chains are less, absent or abnormal.
• In adults, β chains are in excess and in children, γ-
chains are in excess. This leads to defective
erythropoiesis and hemolysis.
• The infants may be stillborn or may die immediately
after birth.

29. β-Thalassemia
• βchains are less in number, absent or abnormal with
an excess of αchains.
• The αchains precipitate causing defective
erythropoiesis and hemolysis.

30. Nutrition Deficiency Anemia

31. • Anemia that occurs due to deficiency of a nutritive
substance necessary for erythropoiesis is called
nutrition deficiency anemia.
• The substances which are necessary for
erythropoiesis are iron, proteins and vitamins like C,
B12 and folic acid.

33. • Iron deficiency anemia is the most common type of
anemia.
• It develops due to inadequate availability of iron for
hemoglobin synthesis.
• RBCs are microcytic and hypochromic.
Causes of iron deficiency anemia:
I. Loss of blood
II. Decreased intake of iron
III. Poor absorption of iron from intestine
IV. Increased demand for iron in conditions like growth
and pregnancy.

34. Features of iron deficiency anemia
Brittle nails, koilonychias, brittle hair, atrophy of
papilla in tongue and dysphagia

35. Protein deficiency anemia
• Due to deficiency of proteins, the synthesis of
hemoglobin is reduced.
• The RBCs are macrocytic and hypochromic.

37. • It is due to atrophy of the gastric mucosa because of
autoimmune destruction of parietal cells.
• The gastric atrophy results in decreased production
of intrinsic factor and poor absorption of vitamin
B12, which is the maturation factor for RBC.
• RBCs are larger and immature with almost normal or
slightly low hemoglobin level.
• Synthesis of hemoglobin is almost normal in this type
of anemia
• Cells are macrocytic and
normochromic/hypochromic

38. Characteristic features
• Lemon yellow color of skin
• Red sore tongue.
• Neurological disorders such as paraesthesia
(abnormal sensations like numbness, tingling,
burning, etc.),
• progressive weakness and ataxia (muscular
incoordination) are also observed in extreme
conditions.

39. Megaloblastic anemia
• Deficiency of another maturation factor called folic
acid.
• RBCs are not matured. The DNA synthesis is also
defective, so the nucleus remains immature.
• The RBCs are megaloblastic and hypochromic.