QPR -Anemias

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Quick Review of Pathology for clinicians and senior students.
Anemias, RBC disorders.

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QPR -Anemias

  1. 1. “ Within the mind are all the resources required for successful living. Ideas are present in the consciousness, which when released and given scope to grow and take shape, can lead to successful events.” - Wings of Fire : An Autobiography of Dr. APJ Abdul Kalam .
  2. 2. Quick Pathology Review Shashidhar Venkatesh Murthy A/Prof.& Head of Pathology School of Medicine & Dentistry James Cook University Australia. Pathology of RBC Disorders System : Hematology Class : RBC disorders Topic : Anemia
  3. 3. Anemia: <ul><li>Aetiology: </li></ul><ul><li>IDA – bleeding, nutrition, growth/pregnancy. </li></ul><ul><li>MCA – Nutrition, anticancer drugs. </li></ul><ul><li>Pathogenesis: </li></ul><ul><li>Decreased production – Deficiency, marrow failure </li></ul><ul><li>Increased destruction – Hemolytic anemia (autoimmune, genetic defects, trauma, parasites). </li></ul><ul><li>Morphology: </li></ul><ul><li>IDA - Microcytic hypochromic, pencil cells. </li></ul><ul><li>MCA - Oval Macrocytic, hypersegmented neurtrophils. </li></ul><ul><li>HA – anisopoikilocytosis, polychromasia, n-RBC + Sp. F. </li></ul><ul><li>Complications: </li></ul><ul><li>Cardiac Failure, SOB, irritability, mood swings. </li></ul><ul><li>Clinical: </li></ul><ul><ul><li>skin, tongue, nail, chelosis, esophageal web. </li></ul></ul>
  4. 4. <ul><li>Iron Deficiency anemia </li></ul><ul><li>Macrocytic anemia </li></ul><ul><li>AIHA - Warm antiboy </li></ul><ul><li>Hereditary spherocytosis </li></ul><ul><li>Cold agglutinin disease </li></ul>?
  5. 5. <ul><li>Haemophilus influenzae infection </li></ul><ul><li>Severe Malaria infection & hemolysis. </li></ul><ul><li>Myolysitis following Hemolysis. </li></ul><ul><li>Block of arteries with sickle cells. </li></ul><ul><li>Release of Kinins following RBC breakdown. </li></ul>?
  6. 6. <ul><li>G6PD Deficiency. </li></ul><ul><li>Pyruvate kinase deficiency. </li></ul><ul><li>Hereditary spherocytosis. </li></ul><ul><li>Thalassemia major. </li></ul><ul><li>AIHA - Warm antibody. </li></ul>Diagnosis ?
  7. 7. <ul><li>Myeoproliferative syndrome. </li></ul><ul><li>Marrow Hyperplasia. </li></ul><ul><li>Aplastic anemia. </li></ul><ul><li>Myelodysplastic syndrome. </li></ul><ul><li>Ideopathic Myelofibrosis. </li></ul>?
  8. 8. <ul><li>Low Haptaglobin levels. </li></ul><ul><li>Increased ESR levels. </li></ul><ul><li>Decreased vitB12 levels. </li></ul><ul><li>Decreased Folate levels. </li></ul><ul><li>Decreased Ferritin levels. </li></ul>?
  9. 9. <ul><li>Myeoproliferative syndrome. </li></ul><ul><li>Marrow Hypoplasia. </li></ul><ul><li>Aplastic anemia. </li></ul><ul><li>Myelodysplastic syndrome. </li></ul><ul><li>Idiopathic Myelofibrosis. </li></ul>Diagnosis ?
  10. 10. <ul><li>Iron Deficiency anemia. </li></ul><ul><li>Megaloblastic anemia. </li></ul><ul><li>Drug induced hemolytic anemia. </li></ul><ul><li>Autoimmune hemolytic anemia. </li></ul><ul><li>Anemia of chronic disease. </li></ul>62y white man, DM2 for 10y. Not well controlled. Presents with SOB, pedal edema, CCF. Echo showed ejection fraction of 30%, hypokinesis in anteroinferior wall. Hb 6.9%, MCV 121 fl, Ferritin 868 mg/L, Creatinine 2.3mg/dl. Image shows his blood film morphology. ? Type of anemia.
  11. 11. <ul><li>Pneumococcal Septicemia. </li></ul><ul><li>Malarial complication. </li></ul><ul><li>AIHA Warm antibody type. </li></ul><ul><li>Drug induced Hemolytic anemia. </li></ul><ul><li>Idiopathic Thrombocytosis. </li></ul>Diagnosis ?
  12. 12. <ul><li>G6PD deficiency. </li></ul><ul><li>Beta Thalassemia. </li></ul><ul><li>Alpha Thalassemia. </li></ul><ul><li>Sickle cell anemia. </li></ul><ul><li>Hereditary spherocytosis. </li></ul>Diagnosis ?
  13. 13. <ul><li>G6PD enzyme </li></ul><ul><li>Anti Trypsin enzyme. </li></ul><ul><li>Pyruvate Kinase </li></ul><ul><li>Haemolysin </li></ul><ul><li>NADPH reductase. </li></ul>?
  14. 14. <ul><li>Iron Deficiency anemia. </li></ul><ul><li>Megaloblastic anemia. </li></ul><ul><li>Drug induced hemolytic anemia. </li></ul><ul><li>Autoimmune hemolytic anemia. </li></ul><ul><li>Anemia of chronic disease. </li></ul>62y white man, DM2 for 10y. Not well controlled. Presents with SOB, pedal edema, ?CCF. Echo Ejection Fraction 30% hypokinesis in anteroinferior wall. Hb 8.9%, Ferritin 568 mg/L, Transferrin saturation 18%, Creatinine 2.3mg/dl. No response to oral iron. Blood film shows mild microcytic hypochromic RBC, mild anisopoikilocytosis. No target cells, no pencil cells. ? Type of anemia.
  15. 15. “ Are you aware of your inner signals? Do you trust them? Do you have the focus of control over your life in your own hands? Take this from me, the more decisions you can make avoiding external pressures, which will constantly try to manipulate and immobilise you, the better your life will be, the better your society will become. The entire nation will benifit from having strong, inner-directed people as their leaders. ” - Wings of Fire : An Autobiography of Dr. APJ Abdul Kalam.

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