Clinical approach to anemia online Flashcards
What is polycythemia?
- AKA “erythrocytosis:
- Increase in # of RBC
- Much less common than anemia
2 types of polycythemias?
Primary: “Polycythemia Vera”
- Abnormality of bone marrow categorized as a myeloproliferative syndrome
- Secondary polycythemia occurs in people who smoke or who live at high altitude
Why do patients who smoke or live at high altitude develop polycythemia?
Low blood O2 stimulates EPO leading to increased production of RBCs and hemoglobin concentration
What are the microcytic anemias?
- Iron deficiency: late stages
- Thalassemias
- Lead poisoning
- Sideroblastic anemia
- Anemia of chronic disease: late stages
What are the non megaloblastic MACROcytic anemias?
- Liver disease
- Alcoholism
- Reticulocytosis
How do you tell if anemia is hyperproliferative or a hypoproliferative state?
Reticulocyte count
Why does anemia artificially elevate RBC count?
- Reported as a % of RBCs
- Because anemia is associated with a total reduction in the number of red blood cells, the percentage of reticulocytes may be artificially elevated
How to calculate corrected retic count?
% of reticulocytes x (pt’s hematocrit / 45)
What is a normal RI?
- 0.5% - 2.0%
- RI 2% indicates hyperproliferation
Symptoms of anemia?
Shortness of breath Weakness Fatigue Insomnia Children - growth retardation and failure to thrive
Questions to ask to detect blood loss anemia?
- Have you had dark, tarry stools?
- Do you have any bright red blood in your stool?
- Have you been coughing up blood?
- Do you have blood in your urine?
- Have you been taking NSAIDs or aspirin?
- Do you have heavy or prolonged menses?
What is melena?
- Dark, tarry stools
- Suggest upper GI bleeding
What is hematochezia?
- Bright red blood in your stool
What is hemoptysis?
Coughing up blood
What is Pica?
Craving for items sch as dirt, clay or chalk.
