Clinical presentation of anemia (3)

Question 1

What is anemia defined as?

Answer 1

Reduction in oxygen carrying capacity of the blood

Question 2

General symptoms of anemia

Answer 2

●Fatigue
●Weakness
●Faintness
●Headache
●Heart palpitations / Tachycardia (as body tries to compensate for lack of oxygenation)
●Pallor
●Low BP (if the body hasn’t compensated to increase blood flow)
●Slight fever

Question 3

Clinical presentation of anemia is _________ dependent…

Answer 3

Time dependent…

In early stages it is usually asymptomatic

Chronic anemia = general symptoms
-fatigue, malaise, headache, exertional dyspnea, angina, pallor, loss of skin tone

Acute anemia = more severe/significant symptoms
-tachycardia, SOB, lightheadedness

Question 4

What labs can we look at to see if anemia is occurring?

Answer 4

Complete blood count (CBC)…

Reticulocytes
-increased if patient has functional bone marrow (trying to compensate for low mature RBCs)

Mean corpuscular (cell) volume (MCV)
-size of RBCs, may be increased as body tries to compensate for low RBCs

Mean cell hemoglobin (MCH) and Mean cell hemoglobin concentration (MCHC)
-reflect hemoglobin amounts, would be low in anemia

Question 5

Cause of microcytic vs macrocytic anemia

Answer 5

Microcytic (small cells … < 80)
-megablastic cells = iron deficiency anemia (IDA)

Macrocytic (large cells … > 100)
-folic acid or B12 deficiency

Question 6

Microcytic anemia signs/symptoms (4)

Answer 6

1. Koilonychia (spoon nails)
   -dip in part of the finger nail that is closer to the finger (easy to see but not present in all patients)
2. Angular stomatitis
   -swollen red patched on corners of mouth or lips
3. Glossitis
   -swollen tongue or change in color/patchy
   (also present in macrocytic anemia)
4. Pica
   -cravings for things that are not food - ice, clay, dirt

Question 7

Macrocytic anemia signs/symptoms

Answer 7

1. Vitamin B12 deficiency (for 3-5 years)
2. Folic acid deficiency (6 months)
3. Ataxia or vertigo
4. Muscle weakness
5. Glossitis (inflamed, patchy tongue)
6. Nerve involvement - loss of vibratory sensation in lower extremities
7. Neuropsychiatric abnormalities (confusion)