Anemia is defined as a deficiency in oxygen-carrying capacity of the blood due to diminished red blood cells. It can be caused by blood loss, decreased red blood cell production, or increased red blood cell destruction. Evaluation of anemia involves assessing hemoglobin, hematocrit, red blood cell count, mean corpuscular volume, and red cell distribution width to classify the type of anemia and guide further testing. Common causes include iron deficiency, vitamin B12 or folate deficiency, blood loss, kidney disease, inflammation, and hereditary disorders.
Information about megaloblastic anemia and it's etiology and its classification.
Vitmain b12 deficiencies
Folic acid deficiencies
Signs and symptoms of megaloblastic anemia
Neural tube defects
- Iron is an essential trace element that is mainly present in blood, liver, bone marrow and muscles. It is required for hemoglobin, myoglobin and other protein synthesis.
- Iron deficiency anemia results from inadequate iron intake, absorption or increased losses and can be diagnosed based on low serum iron, ferritin and transferrin saturation along with microcytic hypochromic anemia.
- Treatment involves oral iron supplementation long-term or intravenous iron for severe cases. Blood transfusions are needed for acute blood loss.
Megaloblastic anemia is caused by impaired DNA synthesis leading to ineffective red blood cell production. It results from vitamin B12 or folate deficiencies. Vitamin B12 is only produced by microorganisms and is obtained through animal products in the diet, while folate is found in many plant foods. Both are required as cofactors in important metabolic reactions. Deficiencies can be due to inadequate intake, impaired absorption, or genetic disorders affecting metabolism. Symptoms include megaloblastic changes in blood cells and pancytopenia.
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.
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.
This document discusses aplastic anemia, a condition characterized by pancytopenia and bone marrow hypocellularity. It defines aplastic anemia, discusses its causes (acquired from things like radiation, drugs, viruses, immune diseases, or inherited genetic syndromes), epidemiology, pathophysiology, clinical features including symptoms and examination findings, diagnostic testing including blood tests and bone marrow biopsy, and treatment options including hematopoietic stem cell transplantation, immunosuppression, supportive care, and prognosis.
Iron deficiency anemia is caused by a lack of iron in the body. Common symptoms include fatigue, palpitations, tinnitus, and headaches. Diagnosis involves blood tests showing low iron levels and microcytic, hypochromic red blood cells. Treatment depends on the severity, and involves oral or intravenous iron supplements to replenish iron stores over 6-12 months. Parenteral iron is used for severe cases or those unable to tolerate oral iron.
This document discusses megaloblastic anemia, which is caused by impaired DNA synthesis leading to ineffective hematopoiesis and abnormally large red blood cells. It can be caused by vitamin B12 or folic acid deficiency. The most common form is pernicious anemia, which is caused by an autoimmune reaction destroying gastric parietal cells and impairing intrinsic factor production needed for B12 absorption. Symptoms include megaloblastic changes in bone marrow and tongue as well as neurological issues. Diagnosis involves testing for anemia, low B12/high homocysteine, and examination of peripheral smear and bone marrow.
Information about megaloblastic anemia and it's etiology and its classification.
Vitmain b12 deficiencies
Folic acid deficiencies
Signs and symptoms of megaloblastic anemia
Neural tube defects
- Iron is an essential trace element that is mainly present in blood, liver, bone marrow and muscles. It is required for hemoglobin, myoglobin and other protein synthesis.
- Iron deficiency anemia results from inadequate iron intake, absorption or increased losses and can be diagnosed based on low serum iron, ferritin and transferrin saturation along with microcytic hypochromic anemia.
- Treatment involves oral iron supplementation long-term or intravenous iron for severe cases. Blood transfusions are needed for acute blood loss.
Megaloblastic anemia is caused by impaired DNA synthesis leading to ineffective red blood cell production. It results from vitamin B12 or folate deficiencies. Vitamin B12 is only produced by microorganisms and is obtained through animal products in the diet, while folate is found in many plant foods. Both are required as cofactors in important metabolic reactions. Deficiencies can be due to inadequate intake, impaired absorption, or genetic disorders affecting metabolism. Symptoms include megaloblastic changes in blood cells and pancytopenia.
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.
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.
This document discusses aplastic anemia, a condition characterized by pancytopenia and bone marrow hypocellularity. It defines aplastic anemia, discusses its causes (acquired from things like radiation, drugs, viruses, immune diseases, or inherited genetic syndromes), epidemiology, pathophysiology, clinical features including symptoms and examination findings, diagnostic testing including blood tests and bone marrow biopsy, and treatment options including hematopoietic stem cell transplantation, immunosuppression, supportive care, and prognosis.
Iron deficiency anemia is caused by a lack of iron in the body. Common symptoms include fatigue, palpitations, tinnitus, and headaches. Diagnosis involves blood tests showing low iron levels and microcytic, hypochromic red blood cells. Treatment depends on the severity, and involves oral or intravenous iron supplements to replenish iron stores over 6-12 months. Parenteral iron is used for severe cases or those unable to tolerate oral iron.
This document discusses megaloblastic anemia, which is caused by impaired DNA synthesis leading to ineffective hematopoiesis and abnormally large red blood cells. It can be caused by vitamin B12 or folic acid deficiency. The most common form is pernicious anemia, which is caused by an autoimmune reaction destroying gastric parietal cells and impairing intrinsic factor production needed for B12 absorption. Symptoms include megaloblastic changes in bone marrow and tongue as well as neurological issues. Diagnosis involves testing for anemia, low B12/high homocysteine, and examination of peripheral smear and bone marrow.
UAEU - CMHS - Hematology-Oncology Course - MMH 302 - HONC 320. Education material for medical students - It cover basic principles of hematology and oncology, including CAR-T and gene editing. It can be used for study and review. It illustrates main principles of hematology and oncology.
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 anemias are caused by deficiencies in vitamin B12 or folate which are needed for DNA synthesis. These deficiencies lead to large, immature red blood cells (megaloblasts) in the bone marrow. Symptoms include anemia, fatigue, weakness, and glossitis. The diagnosis involves blood tests to measure B12, folate, methylmalonate and homocysteine levels as well as examination of bone marrow cells which will show megaloblastic changes and chromosomal abnormalities. Treatment involves replacement of the deficient vitamin with either B12 or folate supplements.
1) Microcytic hypochromic anemia is characterized by small, pale red blood cells and can be caused by iron deficiency, thalassemia, sideroblastic anemia, or other conditions.
2) Iron deficiency anemia is the most common cause and results from inadequate iron intake or absorption. It disrupts hemoglobin synthesis and cellular proliferation.
3) Thalassemia is an inherited disorder of hemoglobin production that can range from mild to severe. Thalassemia major requires regular blood transfusions and causes severe anemia from ineffective erythropoiesis and hemolysis.
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.
Hemolytic anemia is characterized by accelerated red blood cell destruction and vigorous blood regeneration. It can be classified as intrinsic or extrinsic, congenital or acquired. The site of red blood cell destruction can be intravascular or extravascular. Common causes of hemolytic anemia include hereditary spherocytosis, thalassemias, sickle cell anemia, glucose-6-phosphate dehydrogenase deficiency, paroxysmal nocturnal hemoglobinuria, and immune-mediated hemolytic anemia. Evaluation of hemolytic anemia involves determining whether the anemia is hemolytic, the site of red blood cell destruction, the etiology, and severity through blood smears, reticulocyte counts, LDH and
An 18-year-old female presented with symptoms of iron deficiency anemia including weakness, lethargy, and excessive bleeding during menstruation. On examination, she had pale skin and nail beds, swollen tongue, and tachycardia. Blood tests confirmed low hemoglobin, hematocrit, and iron levels. She was diagnosed with iron deficiency anemia based on her symptoms, physical exam findings, and blood test results. Treatment involved oral iron supplementation or parenteral iron therapy depending on severity. The goal of treatment was to raise hemoglobin levels and replenish iron stores.
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.
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 discusses different types of anaemia. It covers the composition of blood and defines anaemia. It describes signs and symptoms of anaemia and discusses causes such as reduced red blood cell production, increased destruction, or blood loss. The document classifies anaemias based on mean corpuscular volume and discusses specific types in more detail including iron deficiency, anaemia of chronic disease, thalassaemia, sickle cell anaemia, and autoimmune haemolytic anaemia. Treatment options are mentioned for some types.
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.
Hemolytic anemias are caused by increased red blood cell destruction. They are characterized by normochromic, normocytic anemia with reticulocytosis, increased indirect bilirubin and LDH, and absent haptoglobin. Causes include membrane defects, metabolic abnormalities, hemoglobinopathies, and immune or non-immune mechanisms. Specific conditions discussed include hereditary spherocytosis, glucose-6-phosphate dehydrogenase deficiency, paroxysmal nocturnal hemoglobinuria, drug-induced hemolysis, alloimmune hemolytic anemia, and warm or cold autoimmune hemolytic anemia. Management depends on the underlying cause and may involve transfusions, medications, or splenectomy.
Vitamin B12 deficiency can result in megaloblastic anemia characterized by large, immature red blood cells. It is most commonly caused by pernicious anemia where autoimmune destruction of gastric parietal cells leads to lack of intrinsic factor needed for vitamin B12 absorption. Clinical features include anemia, jaundice, and neurological problems. Diagnosis is based on morphological changes in blood and bone marrow showing megaloblasts, low vitamin B12 levels, and a positive Schilling test demonstrating impaired absorption. Treatment involves lifelong vitamin B12 injections or high dose oral supplementation.
Megaloblastic anemia is caused by a defect in DNA synthesis due to deficiencies in vitamin B12 or folate. It is characterized by abnormal bone marrow erythroblasts with delayed nuclear development. Causes include dietary deficiencies, malabsorption, increased cell turnover, and drugs. Treatment involves transfusion, vitamin B12 injections or oral folic acid supplementation depending on the underlying deficiency.
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.
1) Megaloblastic anemia is caused by vitamin B12 or folic acid deficiency and results in large, oval red blood cells (macrocytes).
2) Causes of vitamin B12 and folic acid deficiency include lack of intake, increased demands, absorption issues, and autoimmune conditions affecting vitamin B12 absorption.
3) Symptoms include anemia symptoms and neurological symptoms. Laboratory tests show macrocytic anemia with low red blood cell and platelet counts and presence of polysegmented neutrophils.
The document discusses megaloblastic anemia, including its causes, symptoms, diagnosis, treatment, and prognosis. It is caused by vitamin B12 or folate deficiency and results in large, immature red blood cells. Common symptoms include fatigue, shortness of breath, and neurological issues. Diagnosis involves blood tests and medical history. Treatment involves lifelong vitamin B12 injections or high dose oral supplementation to manage symptoms and prevent complications. Prognosis is good with proper treatment but nerve damage may be permanent if untreated for too long.
The document provides an overview of iron metabolism in the human body. It discusses dietary iron sources and requirements, absorption of iron in the small intestine, transport of iron in the blood via transferrin, storage of iron in the liver, spleen and bone marrow as ferritin and hemosiderin, the role of iron in hemoglobin and other proteins, excretion of iron primarily in feces, and laboratory tests to diagnose iron deficiency or overload. Conditions related to iron such as iron deficiency anemia and hemochromatosis are also summarized.
Anemia In The Viewpoint Of Medical, Peadiatrics & ObstetricsMuhammad Helmi
Mariah, a 17-year-old student from Australia who recently moved to Malta, presents with fatigue and dizziness. On examination, she has pale skin and nail beds. Testing reveals microcytic anemia. Iron deficiency anemia is suspected due to her history of migration, fatigue, and examination findings of pallor. Further history and management are needed to confirm the diagnosis and treat the underlying cause of her anemia.
Anaemia for c1 students in JImma university up load by sinboonaSiboona Ararsa
This document discusses anemia, including its definition, pathobiology, classification, causes, clinical presentation, evaluation, and treatment. Anemia is defined as a reduction in circulating red blood cells and can be caused by blood loss, bone marrow disorders, or nutritional deficiencies. The document describes the different types of anemia including iron-deficiency anemia, megaloblastic anemia, aplastic anemia, and anemia related to chronic diseases. Evaluation involves blood tests and bone marrow examination. Treatment depends on the underlying cause but may include oral or intravenous iron, B12, folate supplements, blood transfusions, or addressing underlying diseases.
UAEU - CMHS - Hematology-Oncology Course - MMH 302 - HONC 320. Education material for medical students - It cover basic principles of hematology and oncology, including CAR-T and gene editing. It can be used for study and review. It illustrates main principles of hematology and oncology.
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 anemias are caused by deficiencies in vitamin B12 or folate which are needed for DNA synthesis. These deficiencies lead to large, immature red blood cells (megaloblasts) in the bone marrow. Symptoms include anemia, fatigue, weakness, and glossitis. The diagnosis involves blood tests to measure B12, folate, methylmalonate and homocysteine levels as well as examination of bone marrow cells which will show megaloblastic changes and chromosomal abnormalities. Treatment involves replacement of the deficient vitamin with either B12 or folate supplements.
1) Microcytic hypochromic anemia is characterized by small, pale red blood cells and can be caused by iron deficiency, thalassemia, sideroblastic anemia, or other conditions.
2) Iron deficiency anemia is the most common cause and results from inadequate iron intake or absorption. It disrupts hemoglobin synthesis and cellular proliferation.
3) Thalassemia is an inherited disorder of hemoglobin production that can range from mild to severe. Thalassemia major requires regular blood transfusions and causes severe anemia from ineffective erythropoiesis and hemolysis.
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.
Hemolytic anemia is characterized by accelerated red blood cell destruction and vigorous blood regeneration. It can be classified as intrinsic or extrinsic, congenital or acquired. The site of red blood cell destruction can be intravascular or extravascular. Common causes of hemolytic anemia include hereditary spherocytosis, thalassemias, sickle cell anemia, glucose-6-phosphate dehydrogenase deficiency, paroxysmal nocturnal hemoglobinuria, and immune-mediated hemolytic anemia. Evaluation of hemolytic anemia involves determining whether the anemia is hemolytic, the site of red blood cell destruction, the etiology, and severity through blood smears, reticulocyte counts, LDH and
An 18-year-old female presented with symptoms of iron deficiency anemia including weakness, lethargy, and excessive bleeding during menstruation. On examination, she had pale skin and nail beds, swollen tongue, and tachycardia. Blood tests confirmed low hemoglobin, hematocrit, and iron levels. She was diagnosed with iron deficiency anemia based on her symptoms, physical exam findings, and blood test results. Treatment involved oral iron supplementation or parenteral iron therapy depending on severity. The goal of treatment was to raise hemoglobin levels and replenish iron stores.
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.
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 discusses different types of anaemia. It covers the composition of blood and defines anaemia. It describes signs and symptoms of anaemia and discusses causes such as reduced red blood cell production, increased destruction, or blood loss. The document classifies anaemias based on mean corpuscular volume and discusses specific types in more detail including iron deficiency, anaemia of chronic disease, thalassaemia, sickle cell anaemia, and autoimmune haemolytic anaemia. Treatment options are mentioned for some types.
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.
Hemolytic anemias are caused by increased red blood cell destruction. They are characterized by normochromic, normocytic anemia with reticulocytosis, increased indirect bilirubin and LDH, and absent haptoglobin. Causes include membrane defects, metabolic abnormalities, hemoglobinopathies, and immune or non-immune mechanisms. Specific conditions discussed include hereditary spherocytosis, glucose-6-phosphate dehydrogenase deficiency, paroxysmal nocturnal hemoglobinuria, drug-induced hemolysis, alloimmune hemolytic anemia, and warm or cold autoimmune hemolytic anemia. Management depends on the underlying cause and may involve transfusions, medications, or splenectomy.
Vitamin B12 deficiency can result in megaloblastic anemia characterized by large, immature red blood cells. It is most commonly caused by pernicious anemia where autoimmune destruction of gastric parietal cells leads to lack of intrinsic factor needed for vitamin B12 absorption. Clinical features include anemia, jaundice, and neurological problems. Diagnosis is based on morphological changes in blood and bone marrow showing megaloblasts, low vitamin B12 levels, and a positive Schilling test demonstrating impaired absorption. Treatment involves lifelong vitamin B12 injections or high dose oral supplementation.
Megaloblastic anemia is caused by a defect in DNA synthesis due to deficiencies in vitamin B12 or folate. It is characterized by abnormal bone marrow erythroblasts with delayed nuclear development. Causes include dietary deficiencies, malabsorption, increased cell turnover, and drugs. Treatment involves transfusion, vitamin B12 injections or oral folic acid supplementation depending on the underlying deficiency.
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.
1) Megaloblastic anemia is caused by vitamin B12 or folic acid deficiency and results in large, oval red blood cells (macrocytes).
2) Causes of vitamin B12 and folic acid deficiency include lack of intake, increased demands, absorption issues, and autoimmune conditions affecting vitamin B12 absorption.
3) Symptoms include anemia symptoms and neurological symptoms. Laboratory tests show macrocytic anemia with low red blood cell and platelet counts and presence of polysegmented neutrophils.
The document discusses megaloblastic anemia, including its causes, symptoms, diagnosis, treatment, and prognosis. It is caused by vitamin B12 or folate deficiency and results in large, immature red blood cells. Common symptoms include fatigue, shortness of breath, and neurological issues. Diagnosis involves blood tests and medical history. Treatment involves lifelong vitamin B12 injections or high dose oral supplementation to manage symptoms and prevent complications. Prognosis is good with proper treatment but nerve damage may be permanent if untreated for too long.
The document provides an overview of iron metabolism in the human body. It discusses dietary iron sources and requirements, absorption of iron in the small intestine, transport of iron in the blood via transferrin, storage of iron in the liver, spleen and bone marrow as ferritin and hemosiderin, the role of iron in hemoglobin and other proteins, excretion of iron primarily in feces, and laboratory tests to diagnose iron deficiency or overload. Conditions related to iron such as iron deficiency anemia and hemochromatosis are also summarized.
Anemia In The Viewpoint Of Medical, Peadiatrics & ObstetricsMuhammad Helmi
Mariah, a 17-year-old student from Australia who recently moved to Malta, presents with fatigue and dizziness. On examination, she has pale skin and nail beds. Testing reveals microcytic anemia. Iron deficiency anemia is suspected due to her history of migration, fatigue, and examination findings of pallor. Further history and management are needed to confirm the diagnosis and treat the underlying cause of her anemia.
Anaemia for c1 students in JImma university up load by sinboonaSiboona Ararsa
This document discusses anemia, including its definition, pathobiology, classification, causes, clinical presentation, evaluation, and treatment. Anemia is defined as a reduction in circulating red blood cells and can be caused by blood loss, bone marrow disorders, or nutritional deficiencies. The document describes the different types of anemia including iron-deficiency anemia, megaloblastic anemia, aplastic anemia, and anemia related to chronic diseases. Evaluation involves blood tests and bone marrow examination. Treatment depends on the underlying cause but may include oral or intravenous iron, B12, folate supplements, blood transfusions, or addressing underlying diseases.
This document discusses cyanosis, defined as a bluish or purple discoloration of the skin and mucous membranes due to increased deoxygenated hemoglobin in the blood. There are two main types: peripheral cyanosis, which occurs locally in cold areas due to vasoconstriction; and central cyanosis, which results from imperfect oxygenation in the lungs or a mixing of venous and arterial blood when oxygen saturation falls below 80-85%. Central cyanosis is best seen on the tongue. The document goes on to discuss causes of central cyanosis like birth asphyxia or heart defects, and the differences between central and peripheral cyanosis.
This document discusses cyanosis in children. It defines cyanosis as a bluish discoloration of the skin caused by increased reduced hemoglobin. There are two types: peripheral cyanosis caused by slowed blood flow and central cyanosis caused by low oxygen saturation. Causes of central cyanosis include respiratory disorders like pneumonia, cardiac disorders like congenital heart diseases, and neurological disorders like seizures. Management involves diagnosis of the underlying cause through history, exams, oxygen testing, and imaging like echocardiograms. Treatment depends on the specific condition but may include oxygen, antibiotics for infection, or surgery for heart defects.
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
A 33-year-old male presents with symptoms of fatigue, shortness of breath, palpitations, and headaches for the past 2 weeks. Laboratory tests show macrocytic anemia. Macrocytic anemia is a type of anemia where red blood cells are abnormally large. It can be caused by vitamin B12 or folate deficiencies, such as pernicious anemia which is an autoimmune disorder causing B12 malabsorption. Treatment depends on the underlying cause but may include B12 injections or oral supplements.
This document defines anemia and discusses its causes, signs, and treatment options. Anemia is a low red blood cell or hemoglobin level that can be caused by blood loss, insufficient red blood cell production, or red blood cell destruction. Common causes include iron deficiency, vitamin B12 or folate deficiency, and genetic disorders. Signs of anemia range from fatigue to pale skin and shortness of breath. Treatment depends on the underlying cause but may involve oral iron, B12, folate supplements or B12 injections as well as blood transfusions in severe cases.
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
Anemia (pronounced /əˈniːmiə/, also spelled anaemia or anæmia; from Ancient Greek ἀναιμία anaimia, meaning "lack of blood") is a decrease in normal number of red blood cells (RBCs) or less than the normal quantity of hemoglobin in the blood.[1][2] However, it can include decreased oxygen-binding ability of each hemoglobin molecule due to deformity or lack in numerical development as in some other types of hemoglobin deficiency.
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 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.
7 Anemia full lecture notes for preparing examRAFIULLAHRAFI14
This document defines anemia and describes methods for evaluating and classifying different types of anemia. Anemia is defined as a deficiency in the oxygen-carrying capacity of blood due to low red blood cell mass or hemoglobin. Anemia can be caused by blood loss, decreased red blood cell production, or increased red blood cell destruction. Lab tests like hemoglobin, hematocrit, red blood cell count, mean corpuscular volume, and red cell distribution width are used to classify anemia as microcytic, normocytic, or macrocytic. Specific deficiencies, diseases, and conditions are described as underlying causes of anemia. A systematic approach to evaluating a patient with anemia involves considering possible causes, reviewing lab results
This patient presents with concerning symptoms including weakness, fatigue, shortness of breath, new headache and left-sided weakness, easy bruising, bleeding gums, and fever. Her physical exam reveals a fever and petechiae. Her symptoms and exam are suggestive of thrombotic thrombocytopenic purpura (TTP), which is characterized by thrombocytopenia, microangiopathic hemolytic anemia, fever, renal insufficiency, and neurologic symptoms. A smear would likely show schistocytes, indicating microangiopathic hemolytic anemia. Immediate treatment is needed for this life-threatening condition.
The document discusses various red blood cell disorders and anemias. It covers the etiology, pathogenesis, clinical features, laboratory evaluation, and management of different types of anemias including aplastic anemia, iron deficiency anemia, megaloblastic anemia, anemia of chronic disease, and hemolytic anemias like sickle cell disease. It provides details on the causes, symptoms, diagnostic criteria and treatment approaches for these conditions.
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.
Hemolytic anemia is a condition where red blood cells are destroyed and removed from circulation prematurely. There are many causes of hemolytic anemia including inherited disorders like sickle cell anemia and enzyme deficiencies, immune mediated destruction of red blood cells, infections, toxins and mechanical trauma. Hemolytic anemias can be classified based on location of hemolysis (intravascular or extravascular), source of defect (intracorpuscular or extracorpuscular), and mode of onset (hereditary or acquired). Common symptoms include paleness, fatigue, fever and signs of hemoglobin in urine, blood or stool.
Hemolytic anemias are caused by increased destruction of red blood cells. This document discusses several types of hereditary and autoimmune hemolytic anemias including hereditary spherocytosis, glucose-6-phosphate dehydrogenase deficiency, autoimmune hemolytic anemia (warm and cold types), and paroxysmal nocturnal hemoglobinuria. Signs of hemolysis include jaundice, gallstones, splenomegaly, red blood cell abnormalities, increased LDH and reticulocytes, and a positive Coombs test. Management depends on the specific condition but may include folic acid, steroids, splenectomy, immunosuppression, plasmapheresis or treating any underlying
This document provides an overview of hematological disorders, focusing on anemias and their causes. It discusses the main types of anemia (microcytic, normocytic, macrocytic), and lists common causes for each type. For example, it notes that microcytic anemias can be caused by iron deficiency, thalassemia, or sideroblastic anemia. It also summarizes key lab findings that help differentiate between different anemias, such as iron studies in iron deficiency anemia versus anemia of chronic disease.
Iron-deficiency anemia is caused by blood loss, increased demands, or decreased absorption of iron. It affects over 1/4 of the world's population. Symptoms include fatigue, pallor, and spoon-shaped nails. Laboratory tests show microcytic, hypochromic anemia and low iron levels. Treatment involves oral or parenteral iron supplementation to correct the anemia and restore iron stores.
The document discusses several types of blood disorders that can cause anemia or other issues. It describes red blood cell disorders like iron deficiency anemia, thalassemia, sickle cell anemia and glucose-6-phosphate dehydrogenase deficiency that can lead to hemolytic anemia. It also discusses anemia of chronic disease/inflammation and megaloblastic anemias caused by vitamin B12 or folate deficiencies that result in diminished red blood cell production. Malaria is summarized as a parasitic infection that can cause hemolytic anemia.
Iron-deficiency anemia is caused by blood loss, increased demands from growth or pregnancy, or decreased absorption. It affects over 1/4 of the world's population. Symptoms include fatigue, pallor, and spoon-shaped nails. Laboratory tests show microcytic, hypochromic anemia and low iron levels. Treatment involves oral or parenteral iron supplementation, with oral being preferred.
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.
Target cells, Howell-Jolly bodies, and Heinz bodies seen on blood films can indicate various underlying conditions. A leucoerythroblastic picture seen on blood film is due to bone marrow infiltration and can be seen in malignancies, infections, and vitamin deficiencies. Sickle cell disease is caused by a genetic mutation and results in clinical features like aseptic necrosis. Thalassemia results from globin gene mutations and beta thalassemia major causes severe anemia if untreated. Hereditary spherocytosis is an autosomal dominant condition common in Northern Europeans that causes jaundice and splenomegaly in childhood.
Anemia is defined as a reduction in oxygen-carrying capacity of blood due to low red blood cell count or hemoglobin content. Causes include blood loss, increased red blood cell destruction (hemolytic anemia), and impaired red blood cell production. Hemolytic anemias are characterized by a shortened red blood cell lifespan, increased bone marrow production of red blood cells, and accumulation of hemoglobin breakdown products. Hereditary spherocytosis is caused by a red blood cell membrane defect, while glucose-6-phosphate dehydrogenase deficiency results in hemolytic anemia upon exposure to oxidative stresses. Sickle cell anemia is a hemoglobinopathy where hemoglobin S polymers distort red blood cells into a sickle shape, causing he
Anemia is defined as a reduction in oxygen-carrying capacity of blood due to low red blood cell count or hemoglobin content. Hemolytic anemias are caused by accelerated red blood cell destruction. Sickle cell disease is a hereditary hemoglobinopathy caused by a mutation in the beta globin gene. Homozygotes have severe chronic hemolytic anemia due to sickling of red blood cells under conditions of low oxygen. Clinical manifestations include anemia, bone changes, leg ulcers, infections from functional asplenia. Complications include vaso-occlusive crises, acute chest syndrome, and aplastic crises.
In this presentation I've tried to summarize classification of hemolytic anemia and in depth review of rbc membrane disorders like hereditary spherocytosis, hereditary elliptocytosis, enzymopathies of hemolytic anemia like g6pd disorder, pyruvate kinase disorders, hemoglobinopathies related to hemolytic anemia like thalassemia, sickle cell anemia and especially pathophysiology and mechanism of hemolysis either extravascular or intravascular. Hope it helps you understand the entity better.
This document provides information on anemias, including their classification, red blood cell indices used in diagnosis, red blood cell morphology on peripheral smears, and descriptions of various types of anemias. It begins with definitions of anemia and classifications based on mean corpuscular volume. It then discusses various red cell indices and how they are used in differential diagnosis. The remainder of the document describes different types of anemias in more detail and abnormalities that may be seen on peripheral smear.
This document summarizes various blood disorders that affect red blood cells. It begins by describing anemia of blood loss from acute hemorrhage or chronic blood loss. It then discusses hemolytic anemias, where red blood cells are destroyed faster than normal, including hereditary spherocytosis, sickle cell anemia, and thalassemia. Hereditary spherocytosis is caused by inherited defects in the red blood cell membrane. Sickle cell anemia results from a genetic mutation that causes hemoglobin to polymerize and distort the red blood cells into a sickle shape. Thalassemias are caused by mutations that decrease alpha or beta globin synthesis. The document also reviews impaired red cell production and other acquired
This document provides an overview of anaemia, including its definition, epidemiology, etiology, clinical features, investigations, diagnosis, treatment, complications and prevention. Anaemia is defined as a low level of hemoglobin in the blood. It affects about 30% of the global population and is commonly caused by multiple factors like nutritional deficiencies, blood loss, and increased red blood cell destruction. Clinical features are non-specific and include pallor, fatigue, and breathlessness. Investigations include complete blood count, peripheral smear, iron studies, and bone marrow examination. Treatment involves identifying and treating the underlying cause, as well as oral or intravenous iron, folic acid, vitamin B12 supplementation, or blood transfusions as needed.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
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2. Definition of Anemia
Deficiency in the oxygen-carrying capacity
of the blood due to a diminished
erythrocyte mass.
May be due to:
Erythrocyte loss (bleeding)
Decreased Erythrocyte production
low erythropoietin
Decreased marrow response to erythropoietin
Increased Erythrocyte destruction
(hemolysis)
3. Measurements of Anemia
Hemoglobin = grams of hemoglobin per 100 mL of
whole blood (g/dL)
Hematocrit = percent of a sample of whole blood
occupied by intact red blood cells
RBC = millions of red blood cells per microL of whole
blood
MCV = Mean corpuscular volume
If > 100 → Macrocytic anemia
If 80 – 100 → Normocytic anemia
If < 80 → Microcytic anemia
RDW = Red blood cell distribution width
= (Standard deviation of red cell volume ÷ mean cell
volume) × 100
Normal value is 11-15%
If elevated, suggests large variability in sizes of RBCs
6. Special Considerations in
Determining Anemia
Acute Bleed
Drop in Hgb or Hct may not be shown until 36
to 48 hours after acute bleed (even though
patient may be hypotensive)
Pregnancy
In third trimester, RBC and plasma volume are
expanded by 25 and 50%, respectively.
Labs will show reductions in Hgb, Hct, and RBC
count, often to anemic levels, but according to
RBC mass, they are actually polycythemic
Volume Depletion
Patient’s who are severely volume depleted may
not show anemia until after rehydrated
7. RBC Life Cycle
In the bone marrow, erythropoietin
enhances the growth of differentiation of
burst forming units-erythroid (BFU-E) and
colony forming units-erythroid (CFU-E) into
reticulocytes.
Reticulocyte spends three days maturing in
the marrow, and then one day maturing in
the peripheral blood.
A mature Red Blood Cell circulates in the
peripheral blood for 100 to 120 days.
Under steady state conditions, the rate of
RBC production equals the rate of RBC loss.
9. Causes of Anemia --
Erythrocyte Loss
Bleeding
Chronic (gastrointestinal, menstrual)
Acute/Hemodynamically significant:
Gastrointestinal
Retroperitoneal
10. Anemia due to
Low Erythropoietin
Kidney Disease
Normochromic, normocytic
Low reticulocyte count
Frequently, peripheral smear in uremic
patients show “burr cells” or echinocytes
Target hemoglobin for patients on
dialysis is 11 to 12 g/dL
Administer erythropoietin or darbopoietin
weekly
Good Iron stores must be maintained
12. Anemia due to Decreased
Response to Erythropoietin
Iron-Deficiency
Vitamin B12 Deficiency
Folate Deficiency
Anemia of Chronic Disease
13. Anemia due to Decreased
Response to Erythropoietin
Iron Deficiency
Can result from:
Pregnancy/lactation
Normal growth
Blood loss
Intravascular hemolysis
Gastric bypass
Malabsorption
Iron is absorbed in proximal small bowel; decreased
abosrption in celiac disease, inflammatory bowel
disease
May manifest as PICA
Tendency to eat ice, clay, starch, crunchy materials
May have pallor, koilonychia of the nails, beeturia
Peripheral smear shows microcytic, hypochromic
red cells with marked anisopoikilocytosis.
16. Iron Deficiency Anemia – Lab
Findings
Serum Iron
LOW (< 60 micrograms/dL)
Total Iron Binding Capacity (TIBC)
HIGH ( > 360 micrograms/dL)
Serum Ferritin
LOW (< 20 nanograms/mL)
Can be “falsely”normal in inflammatory
states
17. Treatment of Iron Deficiency
Anemia
Oral iron salts
Ferrous sulfate – 325 mg po Q Day
Side effects: constipation, black stools,
positive hemmoccult test
Vitamin C can facilitate iron absorption.
18. Anemia due to Decreased
Response to Erythropoietin
Cobalamin (Vitamin B12) Deficiency
Macrocytic anemia
Lab Values
Cobalamin level < 200 pg/mL
Elevated serum methylmalonic acid
Elevated serum homocysteine
Vit. B12 is needed for DNA synthesis
Binds to intrinsic factor in the small bowel in order to be
absorbed
Pernicious anemia: antibodies to intrinsic factor
Diagnosed by checking antibody levels (rather than Schilling
test)
Deficiency can result in neuropsychiatric symptoms
Spastic ataxia, psychosis, loss of vibratory sense, dementia
Frequently not reversible with cobalamin replacement
Smear shows macrocytosis with hypersegmentation of
polymorphonuclear cells, with possible basophilic stippling.
21. Anemia due to Decreased
Response to Erythropoietin
Folate Deficiency
Macrocytic anemia
Lab Values
Low folate
Increased serum homocystine
NORMAL methylmalonic acid
Often occurs with decreased oral intake, increased utilization,
or impaired absorption of folate
Folate is normally absorbed in duodenum and proximal jejunum –
deficiency found in celiac disease, regional enteritis,
amyloidosis
Deficiency frequently in alcoholics, because enzyme required for
deglutamation of folate is inhibited by alcohol.
Deficiency often found in pregnant women, persons with
desquamating skin disorders, patients with sickle cell
anemia (and other conditions associated with rapid cell division
and turnover)
Smear shows macrocytosis with hypersegmented neutrophils
23. Treatment of Folate Deficiency
Folate – 1 to 5 mg po Qday
Vit. B12 deficiency must be excluded in
folate-deficient patients, because
supplemental folate can improve the
anemia of Vit. B12 deficiency but not the
neurologic sequelae.
24. Vitamin B12 Deficiency Versus
Folate Deficiency
Vitamin B 12 Folate Deficiency
Deficiency
MCV > 100 > 100
Smear Macrocytosis with Macrocytosis with
hypersegmented hypersegmented
neutrophils neutrophils
Pernicious anemia Yes NO
Homocystine Elevated Elevated
Methylmalonic Acid Elevated NORMAL
25. Anemia due to Decreased
Response to Erythropoietin
Anemia of Chronic Disease
Usually normocytic, normochromic (but
can become hypochromic, microcytic over
time)
Occurs in people with inflammatory
conditions such as collage vascular disease,
malignancy or chronic infection.
Iron replacement is not necessary
May benefit from erythropoietin
supplementation.
26. Anemia due to Decreased
marrow response
Thalassemia
Microcytic anemia
Defects in either the alpha or beta chains of
hemoglobin, leading to ineffective
erythropoiesis and hemolysis
-thalassemia:
Prevalent in Africa, Mediterranean, Middle
East, Asia
-thalassemia:
Prevalent in Mediterranean, South East Asia,
India, Pakistan
Smear shows microcytosis with target cells
28. Anemia due to Destruction of
Red Blood Cells
Hemoglobinopathies
Sickle Cell Anemia
Aplastic Anemia
Decrease in all lines of cells – hemoglobin,
hematocrit, WBC, platelets
Parvovirus B19, EBV, CMV
Acquired aplastic anemia
Hemolytic Anemia
29. Hemolytic Anemias
Hereditary spherocytosis Autoimmune Hemolytic Anemia
Glucose-6-phosphate Warm-antibody mediated
dehydrogenase (G6PD) IgG antibody binds to erythrocyte
Deficiency surface
most common
Most common enzyme defect in
erythrocytes Diagnosed by POSITIVE Coomb’s
Test (detectgs IgG or complement
X-linked on the cell surgace)
Brisk hemolysis when patients Can be caused drugs
exposed to oxidative stress from Treated with corticosteroids or
drugs, infections or toxins. splenectomy if refractory
Thrombotic Thrombocytopenic Cold agglutinin Disease
Purpura (TTP) IgM antibodies bind to erythrocyte
Thrombocytopenia and surface
microangiopathic hemolytic Does not respond to corticosteroids,
anemia, fever, renal but usually mild.
insufficiency, neurologic Infections
symptoms Malaria
Schistocytes on smear Babesiosis
Hemolytic Uremic Syndrome Sepsis
Thrombocytopenia, Trauma
Microangiopathic hemolytic Includes some snake, insect bites
anemia, renal insufficiency
35. Lab Analysis in Hemolytic Anemia
Increased indirect bilirubin
Increased LDH
Increased reticulocyte count
Normal reticulocyte count is 0.5 to 1.5%
> 3% is sign of increased reticulocyte
production, suggestive of hemolysis
Reduced or absent haptoglobin
< 25 mg /dL suggests hemolysis
Haptoglobin binds to free hemoglobin
released after hemolysis
36. Evaluating the Patient with Anemia
Check Hemoglobin/Hematocrit
If female, is Hgb < 12 or Hct < 36?
If male, is Hgb < 13.5 or Hct < 41?
If Yes, Patient has ANEMIA!
If No, they are fine and this lecture was
not necessary.
37. Evaluating the patient with Anemia
Any history of medical problems that
could cause anemia?
Sickle cell Disease?
Thalassemia?
Renal Disease?
Hereditary Spherocytosis?
38. Evaluating the Patient with Anemia
Are the other cell lines also low?
If WBC and platelets are both low, consider
APLASTIC ANEMIA!
Check medication list
NSAIDS (phenylbutazone), Sulfonamides,
Acyclovir, Gancyclovir, chloramphenicol, anti-
epileptics (phenytoin, carbamazepine, valproic
acid), nifedipine
Check parvovirus B19 IgG, IgM
Consider hepatitis viruses, HIV
If Platelets are low consider TTP or HUS!
Must check smear for schistocytes (for sign of
microangiopathic hemolytic anemia)
If renal failure, E. Coli O157:H7 exposure → HUS
If renal failure, neurologic changes, fever → TTP
39. Evaluating the Patient with Anemia
Is the patient bleeding?!
Any bright red blood per rectum
(hematochezia) or black tarry stools
(melena)?
Check stool guaiac, may consider
sigmoidoscopy or colonoscopy
Any abdominal pain, or recent femoral
vein/artery manipulation?
Consider retroperitoneal hematoma
40. Evaluating the Patient with Anemia
If other cell lines are okay, what is the MCV and RDW?
If MCV < 80, then it’s a microcytic anemia
Check serum iron, ferritin, TIBC
If iron-deficiency anemia, look for sources of chronic bleeding –
heavy menstrual bleeding, consider colonoscopy
Consider lead poisoning, copper deficiency, thalassemias
If MCV 80-100, then it’s a normocytic anemia
Any inflammatory conditions that could result in anemia of
chronic disease?
Consider checking indirect bili, LDH, haptoglobin, reticulocyte
count
If MCV > 100, then it’s a macrocytic anemia
Check Vit. B 12, folate
Consider liver disease, alcoholism, myelodysplastic syndrome
Check medications: hydoxyurea, AZT, methotrexate
41. Evaluating the Patient with Anemia
Any jaundice, elevated bilirubin,
suspicious for hemolysis?
Check for increased indirect bilirubin,
increased LDH, decreased haptoglobin,
increased reticulocyte count
Any sign of infection? Malaria?
Babesiosis?
Is Coombs test positive?
If yes, may be warm antibody hemolytic
anemia; Consider drug as cause
42. Case #1
A 41-year old male with a history of
HIV with a CD4 count of 150 who
presents with a Hgb of 11, Hct of 33,
which is down from a Hgb of 14 with
a Hct of 42.
43. Case #1
Denies hematochezia, melena, any
source of bleeding
Denies any yellowing of the skin
No recent fevers, nausea or vomiting.
44. Case #1
PMH: HIV/AIDS
No history of sickle cell disease, cancer, anemia
Allergies: Sulfa
Meds:
Efavirenz
Emtricitabine
Tenofovir
Dapsone
Social History:
No recent travel, no recent sick exposures, lives alone;
occassional alcohol use, no tobacco use, no IV drug use;
Works as attorney
Family History:
No family history of cancer
45. Case #1
P.E.: 37.8, 123/68, 73, 16, 99% on RA
Gen: Alert and oriented x 3; in NAD;
HEENT: no scleral icterus, no
lymphadenopathy
CV: RRR
Resp: LCTA
Abd.: soft, nontender
Ext.: no LE edema
47. Case #1
What lab test do you want to make
sure patient has had already or might
you want to check?
What might you see on peripheral
smear if his total bilirubin was
elevated, and his platelets were low?
48. Case #2
A 34- year old woman presents to your
office with a 1-week history of generalized
weakness, easy fatiguability and shortness
of breath. One hour ago, she developed a
headache a left hemiparesis. Two days
ago, she noted easy bruisability and
bleeding guyms. Three days ago, she
developed a fever. A history reveals that
she had no previous serious illnesses and
review of systems is normal.
49. Case #2
Physical Exam:
Temp: 40°, 120/70, 70, 16, 96% on RA
Gen: Alerti oriented, in NAD, but appears weak
HEENT: petechiae on soft palate with some
fresh blood on gingiva
CV: RRR; II/VI high-pitched holosystolic murmur
Resp: LCTA bilaterally
Neuro: mild left hemiparesis with hyperactive
reflexes and positive babinkski on the left
Skin: scattered pupuric lesions on lower
extremities
52. Case # 2
The most likely diagnosis of this
patient’s disorder is:
(A)Acute leukemia
(B)Bacterial endocarditis
(C)Thromboci thrombocytopenic purpura
(D)Hemolytic uremic syndrome
(E)Systemic Lupus erythematosus
53. Case # 3
A 64-year old woman is hospitalized
because of progressive SOB and
palpitations over the past few weeks. She
has also noticed a yellow tinge to her eyes
during this time. She occasionally drinks
wine excessively but says that she has
abstained since the onset of her symptoms.
For the last 6 months she has not eaten
meat or fish, and her diet has consisted
mostly of toast with margarine, tea, and an
occassional banana. She says her social
security checks do not stretch as far as
they used to.
54. Case # 3
Physical Exam:
Vitals: Pulse: 110, RR: 22
General: pale, blue-eyed, gray-haired
disheveled female with mild scleral
icterus.
CV: RRR
Resp: crackles that do not clear with
coughing are heard at both lung bases
Ext: mild pitting edema at both ankles
Neuro Exam: Normal
56. Case #3
Which of the following blood levels
are most likely in this patient?
Vitamin Folate Methylmalonic Homocysteine
B12 Acid
(A) Low Normal High High
(B) Low Normal Normal High
(C) Normal Low High Normal
(D) Normal Low Normal High
(D) Normal Normal Normal Normal