2. Definition
• Latin: pallere- be pale
• Paleness of skin and mucous membrane due to decreased blood in the
capillary bed.
3. Important cause
• Anaemia
• Important cause - nutritional anemia ( most common)
Iron deficiency, folic acid, vit. B12
Causes of iron deficiency anemia :
Menstrual bleeding
Pregnancy
Hookworm Infestation
Haemorrhoids
Bleeding peptic ulcers
Oesophageal varices
4. Conditions causing Pallor without anaemia
• Hypopituitarism
• Hypothyroidism
• Hypogonadism
• Shock
• Left heart failure
5. Causes of sudden pallor
• Hypertension/shock
• Hypoglycaemia-catecholamine induced
• Drugs like sympathomimetics
• Cocaine use
• Death Pallor
6. Symptoms that may occur with pallor
• Tiredness or fatigue
• palpitation
• Menorrhagia
• Pica
• Syncope
• Bleeding per rectum or burning abdominal pain or melena or anorexia
• Hiccup-seen in patient with CKD
8. Examination
Sites: areas where blood vessels are near to the surface – colour transmit from capillary blood
Lower palpebral conjunctiva
Tips and sides of tongue
Hard palate
Nail bed
Gums
Palms/Palmar crease
Skin
14. Other sites
• Why not the skin?
1. Presence of melanin
2. multilayered skin and away from capillary blood
• Sole? - good site for infants but not useful in adult
16. Method of elicitation of cervical Venous Hum
Auscultate the root of the neck on the
right side with bell of stethoscope,
with patient and standing or sitting
position.
Continuous murmur will be heard
Also called Pontain Murmur
Presence of cervical Venus Hum
indicate chronic compensated severe
Anemia
17. Difficulties
• Pallor without anemia in shock
• Muddy conjunctiva
• Fair skinned individuals
• Dark skinned individuals
• Presence of jaundice with Pallor
• Leukonychia
• Absence or in adequate natural light
