This document provides an overview of anemia. It begins by defining anemia and describing the classification, approach, investigations, and common causes of anemia including iron deficiency, anemia of chronic illness, and megaloblastic anemias. It discusses the pathophysiology, epidemiology, classification, symptoms, signs, and treatment approaches for different types of anemia. Specific details are provided on iron deficiency anemia stages, anemia of chronic illness diagnosis and treatment, vitamin B12 and folate deficiencies, and pernicious anemia.
Iron deficiency anemia is one of the nutritional deficiency anemia, and the most common microcytic hypochromic anemia. it is also one of the common anemia in Pakistan. Pregnant and lactating are most commonly affected.
Iron Deficiency Anemia occurs when iron levels are too low to support normal red blood cell production. It has various causes like bleeding, low dietary iron intake, or loss of iron in the urine. Symptoms include fatigue and pale skin. Investigations show low hemoglobin, ferritin and iron levels with microcytic red blood cells. Treatment involves oral or intravenous iron supplementation depending on severity. Complications can include impaired development in children or increased risk of falls in the elderly. Prevention focuses on consuming iron-rich foods and supplements. Differential diagnoses include thalassemia and anemia of chronic disease.
Anemia is a decrease in red blood cells (RBCs), hemoglobin (Hgb), or hematocrit (HCT) levels compared to normal levels for age and sex. Anemias can be classified based on RBC size and hemoglobin content as normocytic normochromic, microcytic hypochromic, or macrocytic normocytic. Common causes of anemia include iron deficiency, anemia of chronic disease, thalassemia, vitamin B12 or folate deficiency, blood loss, and aplastic anemia.
Iron deficiency anemia is the most common nutritional disorder globally, affecting 30% of the population. It is caused by inadequate iron intake or absorption, blood loss, or increased physiological demands. Common symptoms include pallor, fatigue, and impaired cognitive function. Laboratory findings show microcytic hypochromic anemia, low serum ferritin and iron, and elevated TIBC. Treatment involves oral iron supplementation, while ensuring compliance and watching for malabsorption or ongoing blood loss. Prevention through breastfeeding, iron-fortified formula, and supplements can reduce iron deficiency in at-risk groups like infants and women.
This document summarizes an academic presentation on approaches to patients with anemia. It discusses definitions and classifications of anemia, as well as common types including iron deficiency anemia, anemia of chronic disease, megaloblastic anemias from B12 or folate deficiency, and sickle cell anemia. For each type, it covers etiologies, symptoms, diagnostic findings, bone marrow characteristics, and treatment approaches. Iron deficiency anemia is the most common worldwide and is discussed in depth, including stages of deficiency and management strategies depending on severity and underlying cause of iron loss.
This document discusses anemia, including its definition, classification, symptoms, diagnosis, and treatment. Anemia is characterized by low hemoglobin and red blood cell counts, resulting in reduced oxygen-carrying capacity of blood. It is classified based on cell morphology, etiology, and pathophysiology. Common symptoms include fatigue, weakness, and shortness of breath. Diagnosis involves laboratory tests of hemoglobin, hematocrit, red blood cell indices, iron, vitamin B12, and folate levels. Treatment depends on the underlying cause, and may involve oral or intravenous iron supplementation for iron-deficiency anemia.
This document provides an overview of hematopoiesis, erythropoiesis, and anemia. It discusses where blood cell formation occurs, the lifespan and production rate of red blood cells, and how hypoxia stimulates erythropoietin production. It defines anemia, lists global and country prevalence data, and compensatory mechanisms. It describes classifications of anemia including morphological and etiological, and covers causes such as blood loss, bone marrow disorders, nutritional deficiencies, and hemolytic anemias. Laboratory evaluation of anemia and peripheral blood smear findings are also summarized.
Iron deficiency anemia is one of the nutritional deficiency anemia, and the most common microcytic hypochromic anemia. it is also one of the common anemia in Pakistan. Pregnant and lactating are most commonly affected.
Iron Deficiency Anemia occurs when iron levels are too low to support normal red blood cell production. It has various causes like bleeding, low dietary iron intake, or loss of iron in the urine. Symptoms include fatigue and pale skin. Investigations show low hemoglobin, ferritin and iron levels with microcytic red blood cells. Treatment involves oral or intravenous iron supplementation depending on severity. Complications can include impaired development in children or increased risk of falls in the elderly. Prevention focuses on consuming iron-rich foods and supplements. Differential diagnoses include thalassemia and anemia of chronic disease.
Anemia is a decrease in red blood cells (RBCs), hemoglobin (Hgb), or hematocrit (HCT) levels compared to normal levels for age and sex. Anemias can be classified based on RBC size and hemoglobin content as normocytic normochromic, microcytic hypochromic, or macrocytic normocytic. Common causes of anemia include iron deficiency, anemia of chronic disease, thalassemia, vitamin B12 or folate deficiency, blood loss, and aplastic anemia.
Iron deficiency anemia is the most common nutritional disorder globally, affecting 30% of the population. It is caused by inadequate iron intake or absorption, blood loss, or increased physiological demands. Common symptoms include pallor, fatigue, and impaired cognitive function. Laboratory findings show microcytic hypochromic anemia, low serum ferritin and iron, and elevated TIBC. Treatment involves oral iron supplementation, while ensuring compliance and watching for malabsorption or ongoing blood loss. Prevention through breastfeeding, iron-fortified formula, and supplements can reduce iron deficiency in at-risk groups like infants and women.
This document summarizes an academic presentation on approaches to patients with anemia. It discusses definitions and classifications of anemia, as well as common types including iron deficiency anemia, anemia of chronic disease, megaloblastic anemias from B12 or folate deficiency, and sickle cell anemia. For each type, it covers etiologies, symptoms, diagnostic findings, bone marrow characteristics, and treatment approaches. Iron deficiency anemia is the most common worldwide and is discussed in depth, including stages of deficiency and management strategies depending on severity and underlying cause of iron loss.
This document discusses anemia, including its definition, classification, symptoms, diagnosis, and treatment. Anemia is characterized by low hemoglobin and red blood cell counts, resulting in reduced oxygen-carrying capacity of blood. It is classified based on cell morphology, etiology, and pathophysiology. Common symptoms include fatigue, weakness, and shortness of breath. Diagnosis involves laboratory tests of hemoglobin, hematocrit, red blood cell indices, iron, vitamin B12, and folate levels. Treatment depends on the underlying cause, and may involve oral or intravenous iron supplementation for iron-deficiency anemia.
This document provides an overview of hematopoiesis, erythropoiesis, and anemia. It discusses where blood cell formation occurs, the lifespan and production rate of red blood cells, and how hypoxia stimulates erythropoietin production. It defines anemia, lists global and country prevalence data, and compensatory mechanisms. It describes classifications of anemia including morphological and etiological, and covers causes such as blood loss, bone marrow disorders, nutritional deficiencies, and hemolytic anemias. Laboratory evaluation of anemia and peripheral blood smear findings are also summarized.
The document provides an overview of anemia and iron deficiency anemia. It discusses the typical signs and symptoms of iron deficiency anemia including fatigue, pale skin, spoon-shaped nails, and glossitis. Laboratory findings often show microcytic hypochromic anemia, low serum ferritin, and iron deficiency in bone marrow smears. Treatment involves oral or parenteral iron supplementation for 3-6 months to replenish iron stores.
This document discusses anemia, specifically iron deficiency anemia and megaloblastic anemia. It defines anemia and provides classifications. It then describes iron metabolism, daily iron requirements, sources of iron, and factors affecting iron absorption. It discusses the causes, clinical features, laboratory findings, and management of iron deficiency anemia and megaloblastic anemia. Key points covered include the role of vitamin B12 and folic acid in megaloblastic anemia, and morphological and etiological classifications of anemia.
Iron deficiency anemia is the most common nutritional disorder worldwide caused by inadequate iron intake or excessive iron loss. It develops in stages from depletion of iron stores to microcytic hypochromic anemia. Laboratory findings include low hemoglobin, serum ferritin and iron levels, as well as high TIBC. Peripheral smear shows microcytic hypochromic red blood cells. Bone marrow is hypercellular with iron deficiency and microcytic normoblastic erythropoiesis. Treatment involves oral or parenteral iron supplementation.
This document defines anemia and provides a classification system. It begins by defining anemia as a low level of hemoglobin (Hb) and describes the functions of blood. It then outlines symptoms of anemia and discusses red blood cell indices used in evaluation. Three main classifications of anemia are described: morphological (based on cell appearance), pathological (based on cause), and etiological (based on specific cause). Various types of anemia are listed under each classification, such as iron deficiency under morphological and blood loss under acquired etiological anemia. Normal reference ranges for red blood cell parameters are also provided.
This document provides an overview of iron deficiency anemia, including its definition, pathophysiology, detection, and management. It begins by defining anemia and describing the various causes, including blood loss, inadequate red blood cell production, and excessive red blood cell destruction. Common signs and symptoms of iron deficiency anemia are then outlined. The document concludes by discussing the evaluation, diagnosis, and management of iron deficiency anemia through a case study, focusing on identifying risk factors, signs and symptoms, laboratory findings, and treating with iron supplementation.
This document summarizes anemia, including its definition, classification, causes, signs and symptoms, diagnostic evaluation, and treatment. Anemia is defined as a deficiency in red blood cells, hemoglobin, or hematocrit. It is classified based on size, color, and cause of the red blood cells. Common causes include blood loss, decreased red blood cell production, and increased red blood cell breakdown. Signs and symptoms vary based on severity but can include fatigue, paleness, shortness of breath, and heart palpitations. Diagnostic testing includes complete blood count and iron studies. Treatment involves treating the underlying cause, oral or intravenous iron supplementation, blood transfusions, and medications.
This document discusses iron deficiency anemia, including its normal hemoglobin ranges, classification, etiological factors, signs and symptoms, diagnostic tests, and management. It is classified based on red blood cell morphology and etiology. Causes include low iron diet, growth spurts, GI problems, and blood loss. Diagnostic tests include hemoglobin measurement, complete blood count, peripheral smear, and iron studies. Management involves oral and parental iron therapy, blood transfusion, dietary changes including iron-rich foods, and preventive measures like exclusive breastfeeding and iron-fortified formula.
Megaloblastic Anaemia - Vit B12 deficiencyShahin Hameed
This document discusses megaloblastic anemia caused by vitamin B12 deficiency. It covers the normal metabolism and absorption of vitamin B12, the causes of deficiency including pernicious anemia, clinical features such as macrocytic anemia and neurological changes, diagnostic tests, and management with parenteral B12 injections. Deficiency results in defective DNA synthesis and affects all proliferating cells.
Megaloblastic anemias are caused by impaired DNA synthesis due to vitamin B12 or folate deficiency. The summary examines megaloblastic anemias, including causes such as vitamin B12 or folate metabolism defects, clinical features like pallor and neurological symptoms, investigation findings in peripheral blood and bone marrow showing megaloblasts and macroovalocytes, and treatment involving vitamin B12 or folate supplementation.
This document provides a classification and overview of hemolytic anemia. It discusses intracorpuscular defects like hereditary membrane defects (spherocytosis, elliptocytosis), enzyme defects (G6PD, pyruvate kinase), and hemoglobinopathies. Extracorpuscular defects include immune hemolytic anemia (autoimmune, alloimmune) and nonimmune causes. Evaluation of anemia involves hematological parameters. Thalassemias are classified based on affected globin chain (alpha, beta). Common hereditary spherocytosis causes premature RBC destruction and can be treated with splenectomy. G6PD deficiency results in drug-induced hemolysis.
Iron deficiency anemia is the most common form of anemia globally. It develops due to blood loss, poor diet, or impaired iron absorption. The patient presented has low red blood cell and hemoglobin levels, indicating iron deficiency anemia. Treatment involves oral or intravenous iron supplementation. Oral iron can fully treat most cases of iron deficiency anemia, but often requires 3-6 months for complete recovery. Intravenous iron is recommended when a faster recovery is needed, such as before surgery. Common side effects of oral iron include nausea, abdominal discomfort, and black stools.
Iron deficiency anemia (IDA) is caused by not having enough iron available to make hemoglobin, limiting red blood cell and hemoglobin production and resulting in less oxygen delivery to tissues. IDA is common where meat intake is low and intestinal parasites are present. Symptoms include pallor, fatigue, and weakness. Studies in Saudi Arabia found IDA prevalence of 8.5-55.4% among children and 31.9-32% among pregnant women. Treatment involves iron supplementation and addressing underlying causes, while prevention focuses on iron-rich foods and supplements during pregnancy and breastfeeding.
IDA is the most common form of anemia worldwide, affecting approximately 50% of anemia cases. It results from prolonged negative iron balance in the body due to factors like inadequate iron intake, decreased absorption, increased demand, or blood loss. Diagnosis involves a complete history, physical exam, and lab tests showing low indicators of iron stores like serum ferritin and iron, along with an elevated TIBC. Treatment aims to replenish iron stores and typically consists of oral iron supplementation of 200mg elemental iron per day for 3-6 months.
This document discusses sideroblastic anemia, which is caused by an abnormal accumulation of iron in the mitochondria of red blood cell precursors called ring sideroblasts. There are several types of sideroblastic anemia, including hereditary forms caused by genetic mutations and acquired forms caused by drugs, toxins, or diseases. The condition is characterized by ring sideroblasts seen on bone marrow biopsy along with ineffective red blood cell production and iron overload. Treatment depends on the underlying cause but may include blood transfusions, vitamin supplements, iron chelation therapy, or bone marrow transplant in severe cases.
causes of macrocytic anemia pathopysiology, sign and symptoms and the difference between macrocytic anemia megaloblastIc anemia. causes of hypersegmented neutrophils and its association between them. investigation and medical management plus pictures illustration.
Anemia of chronic disease (ACD), also known as anemia of inflammation, is a common type of anemia associated with chronic infections, inflammatory disorders, and some cancers. It is characterized by inadequate red blood cell production, low serum iron levels, and low iron binding capacity. The anemia is usually mild to moderate in severity. Treatment involves addressing the underlying chronic condition causing the inflammation.
This document discusses anemia, including its definition, classification, causes, symptoms, diagnosis, and treatment. It covers iron deficiency anemia in depth and discusses its stages, signs, and tests. It also covers other nutritional anemias like megaloblastic anemia caused by vitamin B12 or folate deficiencies, copper deficiency anemia, and sideroblastic anemia. Non-nutritional anemias discussed include anemia of chronic disease, sickle cell anemia, thalassemia, and sports anemia. Proper diagnosis is important before providing nutritional or medical management of anemia.
Iron deficiency anemia is a common global health problem affecting 30% of the population. It causes decreased work productivity and increases maternal, child, and infant mortality. Good dietary sources of iron include liver, oats, legumes, and cashew nuts. Iron deficiency can be treated with oral iron supplements taken for 8 weeks, while severe cases may require intravenous iron or blood transfusions. Prevention strategies include iron fortification of infant formula and treating iron deficiency in at-risk groups like adolescent females.
This document summarizes several hematological disorders including anemia, sickle cell anemia, and thalassemia. It discusses the origins and functions of blood, classifications of anemia, causes and symptoms of iron deficiency anemia, and treatments including oral iron therapy and blood transfusions. For sickle cell anemia, it covers alleles, pathophysiology, clinical features like vaso-occlusive crises, and treatments including pain management, oxygenation, and antibiotics. For thalassemia, it discusses decreased synthesis of hemoglobin chains, classifications, clinical features such as prominent facial bones and enlarged organs, diagnosis, and treatments including blood transfusions and iron chelation therapy.
This document discusses anemia in pediatrics. It defines anemia and lists common causes like iron deficiency. Iron is essential for erythropoiesis and its deficiency can cause microcytic anemia. Clinical signs include pallor but may sometimes include more severe symptoms. Laboratory evaluation of iron status includes measurements of iron, ferritin, and TIBC. Iron deficiency anemia is highly prevalent and results from inadequate iron intake or increased demands that outpace supply.
Anemia can be classified based on red blood cell size as microcytic, normocytic, or macrocytic. Microcytic anemias are caused by iron deficiency or thalassemia. Macrocytic anemia is usually megaloblastic due to vitamin B12 or folate deficiency. Normocytic anemias can result from bone marrow diseases, blood loss, or hemolysis. Specific causes of anemia include iron deficiency, B12 or folate deficiency, thalassemia, sickle cell anemia, autoimmune hemolytic anemia, and malaria. Laboratory tests and blood smears are used to classify and diagnose the underlying cause of anemia.
The document discusses different types and causes of anemia. It classifies anemia into etiologic categories including impaired red blood cell production, excessive destruction of RBCs, and blood loss. It further describes morphologic classifications such as macrocytic, microcytic hypochromic, and normocytic normochromic anemia. Specific causes are provided for each category including deficiencies, diseases, and genetic disorders. Hemolytic anemia is discussed in more detail including hereditary and acquired causes. Laboratory findings associated with different types of anemia are also summarized.
The document provides an overview of anemia and iron deficiency anemia. It discusses the typical signs and symptoms of iron deficiency anemia including fatigue, pale skin, spoon-shaped nails, and glossitis. Laboratory findings often show microcytic hypochromic anemia, low serum ferritin, and iron deficiency in bone marrow smears. Treatment involves oral or parenteral iron supplementation for 3-6 months to replenish iron stores.
This document discusses anemia, specifically iron deficiency anemia and megaloblastic anemia. It defines anemia and provides classifications. It then describes iron metabolism, daily iron requirements, sources of iron, and factors affecting iron absorption. It discusses the causes, clinical features, laboratory findings, and management of iron deficiency anemia and megaloblastic anemia. Key points covered include the role of vitamin B12 and folic acid in megaloblastic anemia, and morphological and etiological classifications of anemia.
Iron deficiency anemia is the most common nutritional disorder worldwide caused by inadequate iron intake or excessive iron loss. It develops in stages from depletion of iron stores to microcytic hypochromic anemia. Laboratory findings include low hemoglobin, serum ferritin and iron levels, as well as high TIBC. Peripheral smear shows microcytic hypochromic red blood cells. Bone marrow is hypercellular with iron deficiency and microcytic normoblastic erythropoiesis. Treatment involves oral or parenteral iron supplementation.
This document defines anemia and provides a classification system. It begins by defining anemia as a low level of hemoglobin (Hb) and describes the functions of blood. It then outlines symptoms of anemia and discusses red blood cell indices used in evaluation. Three main classifications of anemia are described: morphological (based on cell appearance), pathological (based on cause), and etiological (based on specific cause). Various types of anemia are listed under each classification, such as iron deficiency under morphological and blood loss under acquired etiological anemia. Normal reference ranges for red blood cell parameters are also provided.
This document provides an overview of iron deficiency anemia, including its definition, pathophysiology, detection, and management. It begins by defining anemia and describing the various causes, including blood loss, inadequate red blood cell production, and excessive red blood cell destruction. Common signs and symptoms of iron deficiency anemia are then outlined. The document concludes by discussing the evaluation, diagnosis, and management of iron deficiency anemia through a case study, focusing on identifying risk factors, signs and symptoms, laboratory findings, and treating with iron supplementation.
This document summarizes anemia, including its definition, classification, causes, signs and symptoms, diagnostic evaluation, and treatment. Anemia is defined as a deficiency in red blood cells, hemoglobin, or hematocrit. It is classified based on size, color, and cause of the red blood cells. Common causes include blood loss, decreased red blood cell production, and increased red blood cell breakdown. Signs and symptoms vary based on severity but can include fatigue, paleness, shortness of breath, and heart palpitations. Diagnostic testing includes complete blood count and iron studies. Treatment involves treating the underlying cause, oral or intravenous iron supplementation, blood transfusions, and medications.
This document discusses iron deficiency anemia, including its normal hemoglobin ranges, classification, etiological factors, signs and symptoms, diagnostic tests, and management. It is classified based on red blood cell morphology and etiology. Causes include low iron diet, growth spurts, GI problems, and blood loss. Diagnostic tests include hemoglobin measurement, complete blood count, peripheral smear, and iron studies. Management involves oral and parental iron therapy, blood transfusion, dietary changes including iron-rich foods, and preventive measures like exclusive breastfeeding and iron-fortified formula.
Megaloblastic Anaemia - Vit B12 deficiencyShahin Hameed
This document discusses megaloblastic anemia caused by vitamin B12 deficiency. It covers the normal metabolism and absorption of vitamin B12, the causes of deficiency including pernicious anemia, clinical features such as macrocytic anemia and neurological changes, diagnostic tests, and management with parenteral B12 injections. Deficiency results in defective DNA synthesis and affects all proliferating cells.
Megaloblastic anemias are caused by impaired DNA synthesis due to vitamin B12 or folate deficiency. The summary examines megaloblastic anemias, including causes such as vitamin B12 or folate metabolism defects, clinical features like pallor and neurological symptoms, investigation findings in peripheral blood and bone marrow showing megaloblasts and macroovalocytes, and treatment involving vitamin B12 or folate supplementation.
This document provides a classification and overview of hemolytic anemia. It discusses intracorpuscular defects like hereditary membrane defects (spherocytosis, elliptocytosis), enzyme defects (G6PD, pyruvate kinase), and hemoglobinopathies. Extracorpuscular defects include immune hemolytic anemia (autoimmune, alloimmune) and nonimmune causes. Evaluation of anemia involves hematological parameters. Thalassemias are classified based on affected globin chain (alpha, beta). Common hereditary spherocytosis causes premature RBC destruction and can be treated with splenectomy. G6PD deficiency results in drug-induced hemolysis.
Iron deficiency anemia is the most common form of anemia globally. It develops due to blood loss, poor diet, or impaired iron absorption. The patient presented has low red blood cell and hemoglobin levels, indicating iron deficiency anemia. Treatment involves oral or intravenous iron supplementation. Oral iron can fully treat most cases of iron deficiency anemia, but often requires 3-6 months for complete recovery. Intravenous iron is recommended when a faster recovery is needed, such as before surgery. Common side effects of oral iron include nausea, abdominal discomfort, and black stools.
Iron deficiency anemia (IDA) is caused by not having enough iron available to make hemoglobin, limiting red blood cell and hemoglobin production and resulting in less oxygen delivery to tissues. IDA is common where meat intake is low and intestinal parasites are present. Symptoms include pallor, fatigue, and weakness. Studies in Saudi Arabia found IDA prevalence of 8.5-55.4% among children and 31.9-32% among pregnant women. Treatment involves iron supplementation and addressing underlying causes, while prevention focuses on iron-rich foods and supplements during pregnancy and breastfeeding.
IDA is the most common form of anemia worldwide, affecting approximately 50% of anemia cases. It results from prolonged negative iron balance in the body due to factors like inadequate iron intake, decreased absorption, increased demand, or blood loss. Diagnosis involves a complete history, physical exam, and lab tests showing low indicators of iron stores like serum ferritin and iron, along with an elevated TIBC. Treatment aims to replenish iron stores and typically consists of oral iron supplementation of 200mg elemental iron per day for 3-6 months.
This document discusses sideroblastic anemia, which is caused by an abnormal accumulation of iron in the mitochondria of red blood cell precursors called ring sideroblasts. There are several types of sideroblastic anemia, including hereditary forms caused by genetic mutations and acquired forms caused by drugs, toxins, or diseases. The condition is characterized by ring sideroblasts seen on bone marrow biopsy along with ineffective red blood cell production and iron overload. Treatment depends on the underlying cause but may include blood transfusions, vitamin supplements, iron chelation therapy, or bone marrow transplant in severe cases.
causes of macrocytic anemia pathopysiology, sign and symptoms and the difference between macrocytic anemia megaloblastIc anemia. causes of hypersegmented neutrophils and its association between them. investigation and medical management plus pictures illustration.
Anemia of chronic disease (ACD), also known as anemia of inflammation, is a common type of anemia associated with chronic infections, inflammatory disorders, and some cancers. It is characterized by inadequate red blood cell production, low serum iron levels, and low iron binding capacity. The anemia is usually mild to moderate in severity. Treatment involves addressing the underlying chronic condition causing the inflammation.
This document discusses anemia, including its definition, classification, causes, symptoms, diagnosis, and treatment. It covers iron deficiency anemia in depth and discusses its stages, signs, and tests. It also covers other nutritional anemias like megaloblastic anemia caused by vitamin B12 or folate deficiencies, copper deficiency anemia, and sideroblastic anemia. Non-nutritional anemias discussed include anemia of chronic disease, sickle cell anemia, thalassemia, and sports anemia. Proper diagnosis is important before providing nutritional or medical management of anemia.
Iron deficiency anemia is a common global health problem affecting 30% of the population. It causes decreased work productivity and increases maternal, child, and infant mortality. Good dietary sources of iron include liver, oats, legumes, and cashew nuts. Iron deficiency can be treated with oral iron supplements taken for 8 weeks, while severe cases may require intravenous iron or blood transfusions. Prevention strategies include iron fortification of infant formula and treating iron deficiency in at-risk groups like adolescent females.
This document summarizes several hematological disorders including anemia, sickle cell anemia, and thalassemia. It discusses the origins and functions of blood, classifications of anemia, causes and symptoms of iron deficiency anemia, and treatments including oral iron therapy and blood transfusions. For sickle cell anemia, it covers alleles, pathophysiology, clinical features like vaso-occlusive crises, and treatments including pain management, oxygenation, and antibiotics. For thalassemia, it discusses decreased synthesis of hemoglobin chains, classifications, clinical features such as prominent facial bones and enlarged organs, diagnosis, and treatments including blood transfusions and iron chelation therapy.
This document discusses anemia in pediatrics. It defines anemia and lists common causes like iron deficiency. Iron is essential for erythropoiesis and its deficiency can cause microcytic anemia. Clinical signs include pallor but may sometimes include more severe symptoms. Laboratory evaluation of iron status includes measurements of iron, ferritin, and TIBC. Iron deficiency anemia is highly prevalent and results from inadequate iron intake or increased demands that outpace supply.
Anemia can be classified based on red blood cell size as microcytic, normocytic, or macrocytic. Microcytic anemias are caused by iron deficiency or thalassemia. Macrocytic anemia is usually megaloblastic due to vitamin B12 or folate deficiency. Normocytic anemias can result from bone marrow diseases, blood loss, or hemolysis. Specific causes of anemia include iron deficiency, B12 or folate deficiency, thalassemia, sickle cell anemia, autoimmune hemolytic anemia, and malaria. Laboratory tests and blood smears are used to classify and diagnose the underlying cause of anemia.
The document discusses different types and causes of anemia. It classifies anemia into etiologic categories including impaired red blood cell production, excessive destruction of RBCs, and blood loss. It further describes morphologic classifications such as macrocytic, microcytic hypochromic, and normocytic normochromic anemia. Specific causes are provided for each category including deficiencies, diseases, and genetic disorders. Hemolytic anemia is discussed in more detail including hereditary and acquired causes. Laboratory findings associated with different types of anemia are also summarized.
This document provides information about anemia. It begins with an introduction stating that anemia is a major problem in India, affecting many women and contributing to maternal deaths. The objectives of the document are then outlined, including defining anemia, classifying types, and discussing causes, symptoms, investigations, treatment and prevention. Several types of anemia are described such as iron deficiency, megaloblastic, and sickle cell anemia. Risk factors, signs and symptoms, normal values, and investigations like hematocrit and hemoglobin levels are explained. The document concludes with sections on management, treatment recommendations including iron supplementation, and benefits of therapy like improved cognition and survival.
The document discusses anemia, including its definition, causes, types, symptoms, diagnosis, treatment, nursing care, and prevention. It provides details on iron deficiency anemia, anemia of chronic disease, thalassemia, sickle cell anemia, and the nursing process for patients with anemia. The document serves as an overview of anemia and aims to educate on this common blood disorder.
This document provides information on anemia, including its definition, classification, pathophysiology, and specific types. Key points:
- Anemia is defined as a low red blood cell count, low hemoglobin levels, or low packed red blood cell volume. It results in an inability to meet oxygen demands.
- Anemia can be classified as microcytic, normocytic, or macrocytic based on mean corpuscular volume. It can also be classified based on cause such as blood loss, decreased production, or increased destruction.
- Common types of anemia discussed include iron deficiency anemia, thalassemia, sickle cell disease, hereditary spherocytosis, glucose-6-
Acute rheumatic fever is a multisystem disease caused by an autoimmune reaction to a Group A streptococcal infection. It commonly affects children between 5-14 years old in developing countries. Symptoms include migratory polyarthritis, carditis, chorea, and skin manifestations. Diagnosis is based on clinical features and evidence of a preceding streptococcal infection. Treatment involves antibiotics to prevent recurrence and symptom relief. Ongoing antibiotic prophylaxis is also needed long-term to prevent recurrence, especially in those who develop cardiac involvement.
This document discusses the classification and evaluation of anemia. It covers:
1. Functional classification including hypoproliferative and destructive causes.
2. Clinical classification based on causes such as blood loss, iron deficiency, or hemolysis.
3. Quantitative classification using hematocrit, hemoglobin, and red blood cell indices like MCV, MCH, and MCHC.
It then provides details on calculating and interpreting various red blood cell indices and describes common red blood cell morphologies seen in different types of anemia.
The document discusses various topics related to hematology including the classification, causes, symptoms, and pathogenesis of different types of anemia, coagulation disorders, bleeding disorders, hematologic cancers, and abnormalities of the lymphoreticular system. Specific topics covered include sickle cell disease, iron deficiency anemia, megaloblastic anemia, disseminated intravascular coagulation, thrombocytopenia, hereditary hemorrhagic telangiectasia, myeloproliferative disorders, leukemia, multiple myeloma, infectious mononucleosis, Hodgkin's disease, and the pathological basis of hematological and lymphoreticular signs and symptoms.
Lipids are water-insoluble organic compounds that include fats, oils, and other compounds. They provide energy, carry fat-soluble vitamins, and serve other important functions. Lipids are classified as simple, complex, or derived. Dietary triglycerides and phospholipids must be broken down before absorption. In the small intestine, pancreatic lipase digests triglycerides into monoacylglycerols and free fatty acids within lipid micelles. These products are then absorbed by intestinal cells and assembled into chylomicrons that enter the lymphatic system and bloodstream.
anemia is define as decrease in Hb concentration below the lower limit of normal value according to the age and sex of the individual is call anemia. anemia can be classify by different ways some are as in this presentation
The major dietary lipids are triacylglycerols, cholesterol, phospholipids, and free fatty acids. Lipids are insoluble in water and require digestion by lipases and emulsification by bile salts to be broken down into absorbable components. In the small intestine, pancreatic lipase breaks triacylglycerols into fatty acids and monoacylglycerols within mixed micelles. Bile salts also aid in emulsifying lipids into smaller particles. Digestion products are absorbed via micelle diffusion and resynthesized into triglycerides and phospholipids within intestinal cells before transport to the liver via the lymphatic system or blood.
Lipid digestion and absorption for medical schoolRavi Kiran
1) Lipids are digested and absorbed through a multi-step process involving emulsification by bile salts and breakdown by pancreatic enzymes in the small intestine.
2) The products of digestion including fatty acids, monoglycerides, and cholesterol are absorbed via micelles and transported across enterocytes.
3) Triglycerides, cholesterol, and phospholipids are reassembled and packaged into chylomicrons for transport to other tissues via the lymphatic system. Bile salts are recycled through the enterohepatic circulation.
Lipids undergo a multi-step digestion and absorption process in the gastrointestinal tract. Dietary lipids are emulsified and broken down into smaller components like fatty acids and monoacylglycerols by lingual and gastric lipases in the stomach and pancreatic lipase in the small intestine. Bile salts produced by the liver play a key role in emulsification. The products of digestion are incorporated into micelles and absorbed by intestinal cells. Inside cells, fatty acids are reassembled into triglycerides and packaged into chylomicrons that enter the lymphatic system and bloodstream for transport to tissues. Defects in digestion, emulsification, or absorption can impair this process.
The document summarizes lipid digestion and absorption. Lipids are broken down by bile and lipase enzymes into fatty acids and monoacylglycerols. These products form micelles that allow absorption by enterocytes, where triglycerides are reformed and packaged into chylomicrons for transport through lymphatic vessels and blood. The liver also synthesizes lipids into VLDL for circulation and metabolism by tissues.
El documento proporciona información sobre las anemias, incluyendo definiciones, factores que influyen en los niveles normales de hemoglobina, mecanismos de compensación del organismo ante la anemia, aspectos a considerar en la historia clínica de pacientes con anemia, manifestaciones clínicas, clasificaciones de las anemias y algunos hallazgos en el frotis sanguíneo y aspirado de médula ósea para diferentes tipos de anemia.
The document classifies anaemia into three main categories: blood loss anaemia, impaired red blood cell production, and excessive red blood cell destruction (haemolytic anaemia). Blood loss anaemia includes overt blood loss from injuries or procedures and occult bleeding from the GI or GU tract. Impaired production is due to nutrient deficiencies like iron, B12, and folate or conditions that suppress red blood cell formation. Excessive destruction includes hereditary defects affecting red blood cell membranes or haemoglobin as well as acquired immune or non-immune causes.
Este documento presenta una definición y clasificación de la anemia. Define la anemia como una disminución de la concentración de hemoglobina por debajo de los límites normales, acompañada de una reducción de glóbulos rojos y hematocrito. Clasifica las anemias según su morfología, funcionalidad, severidad y etiología. Explica las causas comunes de anemia en adultos y niños, así como la fisiopatología, características clínicas y diagnóstico de diferentes tipos de an
El documento describe la anemia, específicamente la anemia ferropénica y la anemia asociada a enfermedades crónicas. La anemia ferropénica es causada por deficiencia de hierro y es la forma más común de anemia. La anemia asociada a enfermedades crónicas ocurre comúnmente en personas con enfermedades como cáncer e infecciones y causa una anemia leve. El documento también cubre los síntomas, exámenes de laboratorio y tratamientos para estos tipos de anemia.
Lipids are digested and absorbed in a multi-step process involving enzymes in the mouth, stomach, and small intestine. In the mouth, lingual lipase begins hydrolysis of triglycerides. In the stomach, gastric lipase continues this process. In the small intestine, pancreatic lipase works with bile salts to further digest triglycerides into fatty acids and monoglycerides. Bile salts emulsify lipids and facilitate absorption. Fatty acids and monoglycerides are absorbed into intestinal cells and re-esterified into triglycerides. These triglycerides are packaged into chylomicrons and enter the lymphatic system for transport.
Irion defitient and megaloblastic anemiasJasmine John
This document summarizes iron deficiency anemia and megaloblastic anemia. It discusses the causes, symptoms, laboratory findings, treatment, and prognosis of these conditions. Iron deficiency is the most common cause of anemia worldwide and results from inadequate iron intake or absorption. Megaloblastic anemia is caused by vitamin B12 or folate deficiencies and results in abnormal DNA synthesis and large, immature red blood cells. Treatment involves oral or intravenous iron supplementation for iron deficiency and vitamin B12/folate supplementation for megaloblastic anemia.
1. The document discusses hematologic disorders including hematopoiesis, anemia, polycythemia, and hematologic malignancy.
2. It provides details on the pathophysiology of hematopoiesis, the definition and classification of anemia, the general approach to evaluating anemic patients, and discussions of common anemia types and their treatments.
3. Key anemia types covered include iron deficiency anemia, megaloblastic anemia due to vitamin B12 and folate deficiencies, and the morphological features seen in peripheral blood and bone marrow in these conditions.
This document provides an outline and summary of a seminar presentation on approaching patients with anemia. It discusses the definition and classification of anemia and covers several common types of anemia - iron deficiency anemia, anemia of chronic disease, megaloblastic anemias, sickle cell anemia, and thalassemia. For each type of anemia, the document outlines etiologies, symptoms, diagnostic criteria, bone marrow findings, and treatment approaches.
The document defines anaemia and describes its classification and types. It is classified into morphological anaemia, based on changes seen in red blood cells, and etiological anaemia, based on the underlying cause. The key types of morphological anaemia are normocytic normochromic, microcytic hypochromic, and macrocytic normochromic. Etiological anaemia includes anaemia due to blood loss, nutritional deficiencies, bone marrow failure, and haemolytic anaemia. Common causes, clinical features, laboratory findings, and treatments are discussed for different types of anaemia.
The document discusses anti-anemic drugs used to treat different types of anemia. It covers iron, cyanocobalamin, folic acid, erythropoietin, and hydroxyurea. Iron is used orally or parenterally to treat iron deficiency anemia. Cyanocobalamin and folic acid are given to treat megaloblastic anemia. Erythropoietin stimulates red blood cell production and is used for anemia of renal failure. Hydroxyurea increases fetal hemoglobin levels and is used for sickle cell disease.
This document provides information on laboratory diagnosis of red blood cell disorders. It discusses various red blood cell indices and their reference ranges. It then covers various types of anemias including iron deficiency anemia, megaloblastic anemia, sickle cell anemia, erythroblastosis fetalis, thalassemia, and aplastic anemia. The diagnostic workup and features of each disorder are summarized. Red cell morphology changes seen in different conditions are also outlined.
This document provides an overview of anemia, including its definition, cut-off levels used to diagnose it, common causes, classification approaches, and key details about specific types like iron deficiency anemia, megaloblastic anemias, sickle cell disease, and thalassemias. It covers diagnostic testing and clinical manifestations, emphasizing the importance of considering a patient's red blood cell morphology, erythropoiesis, and underlying pathophysiology when evaluating the cause of an anemia.
This document discusses anemias in children. It begins by defining anemia and classifying it based on etiology into impaired red cell formation, blood loss, and hemolytic anemia. It then describes the diagnosis of anemia through history, physical exam, and laboratory tests. Specific types of anemia are summarized, including iron deficiency anemia, megaloblastic anemia, bone marrow failure disorders like Diamond Blackfan anemia, and hemolytic anemias. Causes, clinical features, diagnosis, and treatment are provided for several common pediatric anemias.
This document discusses megaloblastic anemias, which are caused by deficiencies in vitamin B12 or folic acid. It describes the mechanisms by which these vitamins function in DNA synthesis and the effects of their deficiencies. It provides details on pernicious anemia, a type of megaloblastic anemia caused by autoimmune destruction of gastric parietal cells leading to impaired vitamin B12 absorption. The clinical features, morphological findings, investigations, and management of megaloblastic anemias and pernicious anemia specifically are summarized.
Iron deficiency anemia is the most common type of anemia globally. It results from inadequate iron intake or absorption to meet physiological needs. Common symptoms include pallor, weakness, and fatigue. Diagnosis involves blood tests showing microcytic hypochromic anemia, low serum iron and ferritin levels, and high total iron binding capacity. Treatment consists of oral iron supplementation in the form of ferrous salts to replenish iron stores.
This document discusses anemias in children. It begins by defining anemia and classifying it based on etiology into impaired red cell formation, blood loss, and hemolytic anemia. It then describes the diagnosis of anemia through history, physical exam, and laboratory tests. Specific types of anemia are discussed in more detail, including iron deficiency anemia, megaloblastic anemia, bone marrow failure, Diamond-Blackfan anemia, Fanconi anemia, acquired aplastic anemia, and hemolytic anemias. Treatment options are provided for each condition.
This document discusses anemias in children. It begins by defining anemia and classifying it based on etiology into impaired red cell formation, blood loss, and hemolytic anemia. It then describes the diagnosis of anemia through history, physical exam, and laboratory tests. Specific types of anemia are discussed in more detail, including iron deficiency anemia, megaloblastic anemia, bone marrow failure, Diamond-Blackfan anemia, Fanconi anemia, acquired aplastic anemia, and hemolytic anemias. Treatment options are provided for each condition.
The diagnosis is vitamin B12 deficiency (pernicious anemia).
The neurologic findings can be explained by the fact that severe B12 deficiency can damage the dorsal and lateral columns of the spinal cord, leading to decreased vibratory sense, loss of position sense in the joints, and possibly ataxia. This is because B12 is essential for myelin formation and maintenance in the nervous system.
The next step would be to measure the patient's serum B12 level and consider treatment with parenteral B12 injections if deficient.
Approach to a case of iron defciency anaemiaSachin Adukia
- Anaemia is defined as a reduction in haemoglobin, red blood cell count or haematocrit below normal levels. Iron-deficiency anaemia affects around 2 billion people worldwide including 20-40% of people in India.
- Iron-deficiency anaemia is classified based on the underlying cause such as reduced red blood cell production, increased red blood cell destruction, or loss of red blood cells.
- Diagnosis involves examination of symptoms, signs, and laboratory tests including a blood smear, iron studies, and bone marrow examination. Treatment involves oral or intravenous iron supplementation depending on the severity of the deficiency.
This document discusses megaloblastic anemias, which are caused by a deficiency in vitamin B12 or folic acid. These deficiencies impair DNA synthesis during erythropoiesis, leading to large, abnormally developed red blood cells. Key findings include macrocytic anemia, hypersegmented neutrophils, and megaloblasts visible in bone marrow samples showing nuclear-cytoplasmic asynchrony. Pernicious anemia, an autoimmune disorder causing vitamin B12 deficiency, is described. Treatment involves vitamin B12 or folate supplementation.
This document discusses megaloblastic anemia caused by vitamin B12 or folic acid deficiency. It covers the historical background, structures and roles of vitamin B12 and folic acid, causes and clinical presentations of deficiency, hematological findings, and neurological effects. Diagnosis involves assessing macrocytic anemia and hematological features showing megaloblastic changes. Treatment involves replacing the deficient vitamin.
Anaemia is defined as a reduction in haemoglobin, red blood cells or haematocrit below normal levels. Iron-deficiency anaemia (IDA) affects around 2 billion people worldwide. IDA is prevalent in India, affecting 20% of adult males, 40% of non-pregnant females and children, and 80% of pregnant females. IDA is classified based on its underlying cause such as reduced red blood cell production or increased destruction. Oral iron therapy is usually the first line treatment, while blood transfusions or intravenous iron may be used for more severe cases or those who cannot tolerate oral iron. The diagnosis of IDA relies on a low MCV, MCH and iron studies showing low ferritin and transferrin saturation
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
2. Introduction
• Definition - A reduction of the Hemoglobin
concentration,or Hematocrite, to below normal levels.
• The likelihood and severity of anemia are
defined based on deviation of patients hgb or
hct from values expected for age & sex
matched normal.
Sex normal (hct) anemia
(hct/hgb)
male 47 (± 7) % < 39 (13g/dl)
3. Pathophysiology
• Erythropoiesis is the process of RBC
production in the erythroid bone marrow
under the influence of stromal
network,cytokins ,EPO (erythroid specific
growth factor or hormone)
• Erythropietin (EPO) is a glycoprotein
produced in the kidney in response to a
sense of hypoxia.
• Normal BM which is repleted by
Fe, Folate and cobalamine will increase
4. Epidemology
• Research done in gondar indicates
prevalence of anemia in rural population of
gondar to be 40.5% and was 4th leading
cause of hospitalization & death in 1982.
• 1987, in black lion it was the 3rd cause of
hematolgic admissions.
• Iron deficiency anemia is the commonest
type globally and especially in developing
country like ours,Ethiopia.
5. Çlassifiçation
1. Pathophysiologiç
Hypoproliferative anemia
Maturation disorder
Anemia due to inçreased
destruçtion/blood loss
2. Morphologiç
Noromoçytiç normoçhromiç
Maçroçytiç
Miçroçytiç hypoçhromiç
6.
7. Approaçh to a patient
• Thorough history and P/E gives a çruçial
information to the cause and severity of
anemia.
• Sxs depend on the rapidity of anemia
devt,severity,age,presence of underlying
ds....
• Usually the body tries to çomensate mild
anemias and chronic anemias by different
mechanisms:
8. Çont’d
– Increased cardiac output when tissue
demand for oxygen increases, and
decrease in PVR to increase perfusion of
tissues.
– Redistribusion of blood flow from less
vital organs to vital organs.
– Increased bone marrow in response to
decrease in red cell mass.
** But this compensatory mechanisms fail if
9. Symptoms of anemia
• Non specific
• Fatigue
,dizziness,palpitation,sweating,angina,
exercise and cold
intolerance,tinnitus,verigo,
nausea,anorexia,bowel habit change .....
• Sxs of underlying disease; wt loss,fever,gi
bleeding bone pain etc
• Neurologic –irritability,difficulity
concentrating, tingling and
10. Signs
HEENT- pale conjuctiva,atrophied and beefy
tongue
angular stomatitis
LGS –lymphadenopathy
CVS –tachycardia,wide pulse pressure,ejeçtion
sys.
murmur,signs of CHF
11. Signs çont’d
GUS – bleeding..
Skin and muçous membrane
– pallor,peteçhea,içterus,spooning of finger
nails
MSS –bone tenderness
Neurologiç exam –sensory or motor
abnormalities
Fundusçopy- retinal hemmorage
12. Investigations
1 Complete blood count
A RBC count
• Hemoglobin
• Hct
• Reticulocyte count
B Red cell indicis
• Mcv (mean corpuscular volume) 80-100 fl
normal
< 80fl microcytic
> 100fl macrocytic
13. Invgn cont’d
• MCH( mean corpuscular hgb) 27 -36 pg
• MCHC (mean corpuscular hgb concentration) 32-
36%
The above two measures indicate defect in hgb
synthesis.
C -WBC count
D -Paletlate count
E –morphology
• size (anisocytosis)
• shape (poikilocytosis)
• hgb content
14.
15. 2 Iron supply studies
– Serum iron level
– Total iron binding capacity
– Serrum ferritin
3 bone marrow exam ( aspiration,biopsy)
– M:E ratio
– Morphology
– Iron stain (prussian stain)
– Cellularity
4 work up for underlying causes
Eg tuberculosis,leishmaniasis,cancer, CRF,HIV
.......
16. Iron deficiency anemia
• Commonest cause of anemia.
• Causes both hypoproliferative disorder (mild to
moderate ) and ineffective erythropoiesis or
maturation disorder ( severe deficiency).
• Marrow only synthesizes hgb when there is
adequate Fe available.
• The only natural source of Fe is diet (1-1.4mg/d)
absorbed in the duodenum and jejnum circulation
bound to transferrin ( transport protein) enters to
BM &
in mitocondria,Fe is realeased and transf.returns
back some part is used for heme synthesis and
the rest is stored as ferritin (storage form)
When the RBC dies the Fe recycles back.
17. Causes of Fe def. anemia
1- Increased demand
– Pregnancy
– Infancy
– Blood loss
2- Increased loss
Blood loss ( mensus,hookworm ,gi loss)
3- Decreased intake and malabsorption
iron in vegetables ( w/ch contain phytates,phosphate
decrease abs.)
but Fe in liver, meat is absorbed well.
18. stages of iron deficiency
anemia
1st negative iron balance
**Demands exceed absorption,early phase
– Ferritin starts to fall
– BM stainability decreases
– Serum iron (SI) normal
– TIBC – normal
– Transferrin saturation –normal
2nd Fe deficient erythropoiesis
- iron store is depleted
19.
20. Stages cont’d
– Serum iron level begin to fall
– TIBC increases
– Transferrin saturation falls (<20%)
– Morphology may remain normal
3rd Fe deficiency anemia
– Microcytic hypochromic
– Fall in hgb and hct
– TS falls (<10-15%)
– Poikiloanisocytosis
– Ineffective erythropoisis
21. • Sxs of Fe deficiency are similar to the
general sign & symptoms of anemia but
:pica
Cheilosis , Koilonychia may be specific for Fe def. A
• Treatment
- Severe anemia with heart failure
(uncompensated ) should be rxed with blood
transfusion.
- Compensated anemia- Fe replacment
- Oral or parentral preparations
- Hgb will normalize by 6-8 wks
- But to replace store, Rx should continue for 4-
6month.
22. Anemia of chronic illness
• Includes
– infection ( TB,HIV)
– Inflammation (RA,Crhon’s ds)
– Maliganancy
– Cronic renal failure, liver disease
• Impotant DDx of fe def anemia b/se effects are due to
inadequate delivery of Fe to BM despite nl or
increases iron stores.
• Mzm of damage
Hepsidine – decrease Fe absorption and release from
storage forms
IL-1 directly decreases EPO production
TNF & IFN gamma –suppress the response of Bm to EPO
23. Diagnosis
• Usually anemia is mild to moderate
• Serum iron- low
• TS – low 15-20%
• Ferritin –normal or increased
• Marrow –hypocellular
• Other comorbid conditions evidenced from
HX,P/E and lab findings.
24. Treatment
• Treatment of underlying factors
• EPO supplementation for CRF
• Transfusion.
• Avoid iron supplementation.
25. Megaloblastic anemias
• This are disorders caused by imapaired
DNA synthesis which helps for cells to
mature
• Only cell division is affected so cytoplasmic
maturation will not be affected so
eventhough the marrow production is
normal or increased but the cells get
dystroyed easily (ineffective
erythropoisis).
29. Cobalamin (Vitamin B12)
deficiency
Function –cofactor for 2 enzymes Methionine Synthase and
methylmalonyl coA mutase which are involved in many
reactions,esp DNA metablism.
Causes
1 nutritional- vegeterians
2 malabsorption (commonest)
A -gastic causes
– Achlorhydria
– Pernicious anemia (commonest)
– Congenital lack or abnormality of IF
– Total or partial gasrectomy
30. Enteric Processing and absorption
of Cobalamin
Stomach Food-Cbl
H+ Peptic
digestion
Cbl + R-binder
R-Cbl
Duodenum
Pancreatic
enzymes Cbl-TC complex
IF + Cb R-Cbl
OH -
Cbl-IF
Distal ileum
IF receptor Cbl + TC
Cbl-IF
31. Causes cont’d
B intestinal causes
– Ileal disease (crhon’s ds,tropical sprue)
– Bacterial overgrowth ,diphlobotrium latum--
competes for VB12.
– Past ileal resection
C Rare causes
– Transcobalamin deficency
– drugs
32. Pernicious Anemia
• Most common cause of vitamin B12 deficiency
• Occurs in all ages and ethnic backgrounds
• Results from immunologic destruction of
parietal cells in stomach( antrum) which
produces IF,like in atrophic gastritis.
• ~90 % patients show parietal cell antibody.
• Schilling test helps to identify underlying
cause of Vb12 deficincy.
• 24 hr urine cobalamine excreted is
measured,normally > 8% should be
excreted,but if not,it may indicate Vb12
malabsorption.
34. C/f of VB12 & folate
Hematologic, Gi, neurologic ( only for VB 12 deficiency)
Hematologic
Anemia (macrocytic)
May –leucopenia and thrombocytopenia
Pts have symptoms of anemia, stms bleeding.
GI
b/se GI epithelial cells are rapidly proliferating cells.
Pts may experiance symptoms of malabsorption like diarrihea.
Sore ,beefy tongue
Neurologic ( demylination and axonal degeneration)
Sxs – Spinal cord or PNS
arestesia or numbness,weakness,sphincter disturbance,reflexes depressed
or increased ,position and vibration sense loss.
37. MEGALOBLASTIC ANEMIAS
Diagnosis(2)
3. Laboratory features
• indirect hyperbilirubinemia
• elevation of lactate dehrogenase (LDH)
• serum iron concentration- normal or increased
4. Bone marrow smear
• hypercellular
• increased erythroid /myeloid ratio
• erythroid cell changes (megaloblasts, RBC precursor a abnormally large with nuclear-
cytoplasmic asynchrony)
• myeloid cell changes (giant bands and metamyelocytes , hypertsegmentation)
• megakariocytes are decreased and show abnormal morphology
5 serum levels of folate and cobalamine should be measured.
37
38. Treatment of VB12 def.
Anemia
• Almost always malabsorption,so Rx should be
parentral.
• 1000µg IM weekly for 8wks followed by
1000µg once every month for life.
• emperical treatment with folate may correct the
anemia but if pt has neurologic
manifestations,may even worse the condition.
• Neurologic complications may fail to respond to Rx
39. RX of FOLIC ACID DEFICIENCY
ANEMIA
1. Oral administration of folic acid 1 to 5 mg per day, for 3
months, and maintance therapy if it’s necessary.
2. Reticulocytosis after 5-7 days
3. Correction of anemia is over after 1-2 months
therapy
39
40. Aplastic Anemia
• Inherited, but can be acquired from chemical
exposure or radiation
• Other causes- viral (
EBV,HIV,Heptitis,parvovirus B19 ),
pregnancy
• Failure of bone marrow to produce adequate
amounts of RBCs, leukocytes, & platelets
• Pancytopenia
• Usually seen in young individual, median age 25
years
41. Aplastic Anemia, cont.
• BM suppression, destruction or aplasia resulting in
failure of BM to produce adequate no of stem cells
• Biopsy
– BM cellularity < 25%
• If severe (ANC < 500/ul) & platelet < 20,000/ul
and retic count < 60000/ul
43. Diagnostic Tests
• degeneration with Prepheral blood smear -
pancytopenia
• BM biopsy- fatty few or no stem cells.
Treatment
• Stem cell transplantation
• Bm transplant
• Blood transfusion
• Without treatment – rapid deterioration & death.
44.
45.
46. • There are also other many causes of
anemia including hemolytic anemias
(intravascular &extra-avascular),blood
loss,mylofibrosis, myelophythias
(infiltrative ds by tumor,infection), MDS.
• Presentation of almost all forms of anemia
are similar.
• Transfusion is indicated for patients with
decompensated anemia.