45. Anemia. Classification

Question 1

What is anemia?

Answer 1

A condition characterized by a deficiency of red blood cells or hemoglobin, leading to reduced oxygen transport in the blood.

Question 2

What causes anemic syndrome?

Answer 2

Caused by decreased hemoglobin (130-180 g/L in males, 115-160 g/L in females) and erythrocyte (4-6 x 10¹²/L) levels, resulting in disrupted gas exchange and tissue hypoxia.

Question 3

What are the classifications of anemia by etiology?

Answer 3

1. Blood Loss Anemia: Acute (trauma, surgery), Chronic (GI bleeding, heavy menstruation). 2. Decreased RBC Production: Nutrient Deficiencies (iron, vitamin B12, folate), Bone Marrow Disorders (aplastic anemia, myelodysplastic syndromes), Chronic Diseases (chronic kidney disease, chronic infections, cancer). 3. Increased RBC Destruction: Inherited Disorders (sickle cell anemia, thalassemia, hereditary spherocytosis), Acquired Conditions (autoimmune hemolytic anemia, hemolytic anemia due to infections, drug-induced hemolytic anemia).

Question 4

What is microcytic anemia?

Answer 4

Microcytic Anemia (MCV lower than 80 fL): Includes iron deficiency anemia, anemia of chronic disease, globin synthesis defect (thalassemia), sideroblastic defect.

Question 5

What is normocytic anemia?

Answer 5

Normocytic Anemia (MCV 80-100 fL): Includes acute blood loss, chronic disease, hemolytic anemia, bone marrow disorders (aplastic anemia), chronic kidney disease.

Question 6

What is macrocytic anemia?

Answer 6

Macrocytic Anemia (MCV > 100 fL): Includes vitamin B12 deficiency, folate deficiency, alcoholism, liver disease, hypothyroidism, drugs that inhibit DNA replication (methotrexate).

Question 7

What is the treatment for iron deficiency anemia?

Answer 7

Oral Iron (Ferrous sulfate 325 mg 3x/day), IV Iron (for intolerance or malabsorption), eat iron-rich foods.

Question 8

What is the treatment for vitamin B12 deficiency?

Answer 8

Parenteral B12 (1000 mcg IM weekly) then monthly, Oral B12 (1000-2000 mcg daily).

Question 9

What is the treatment for folate deficiency?

Answer 9

Oral Folic Acid (1 mg daily).

Question 10

What is the treatment for hemolytic anemia?

Answer 10

Corticosteroids (autoimmune hemolytic anemia), transfusions (severe cases), folic acid.

Question 11

What is the treatment for sickle cell anemia?

Answer 11

Hydroxyurea, opioids (for pain), transfusions, bone marrow transplant.