Intro to Anemia Flashcards
Define Anemia?
Inability of the blood to supply tissue W/adequate oxygen for proper metabolic function.
Clinical Definition of Anemia?
A decrease in the normal concentration of Hb or Eryths.
Anemia is not a disease, but a?
Expression of an underlying disorder or disease.
Important components of making a clinical diagnosis of anemia?
History and physical exam
Decrease in Oxygen delivery to the tissues decreases the PTs?
Energy for day to day activities (Fatigue).
Classic symptoms associated W/ anemia?
Fatigue & Shortness of breath (SOB)
Common signs and symptoms of Anemia?
Petechiae of the skin
Eye-pallor, jaundice, hemorrhage
Mouth-mucosal bleeding
Why is jaundice important in the assessment anemia?
B/c it may be due to increased RBC destruction.
This would suggest a hemolytic component of the anemia.
True Anemia
Decreased RBC mass
Normal plasma volume
Hgb 10.0 g/dL
Hct 30.0%
Pseudo/Dilutional Anemia
Normal RBC Mass
Increased plasma volume
(Pregnancy, Volume Overload, Congestive Heart Failure).
Hgb: 10.0 g/dL
Hct: 30.0%
8 Causes of Anemia
Hemorrhage
Accelerated RBC destruction (Immune or Non-Immune)
Nutritional Deficiency (Iron, B-12, Folate)
BM Replacement (Cancer)
Infection
Toxicity
Hematopoietic SC arrest/damage
Hereditary/Acquired Defect
Accelerated BM Erythropoiesis signs?
BM hypercellular
NRBCs may be released W/ retic.
(Correlates W/ severe anemia)
Demand exceeds max BM activity
(Extramedullary sites production).
Morphological classification of anemia?
Erythrocyte indices
Erythrocyte Indices
MCV
MCH
MCHC
Types of Morph Classifications of Anemias? Diseases associated?
Macrocytic, Normochromic
(Megaloblastic Anemias)
Normochromic, Normocytic
(BM Failure, Chronic Renal Failure, Leukemias)
Microcytic, Hypochromic (Most Common)
(IDA, SA, Thalassemias, Chronic Diseases)
Etiologic Classifications of Anemia? Diseases associated?
- Maturation Defect:
- Decreased Hgb Synth
- Microcytic/Hypochromic
- Normal-Low Retics
- Diagnosis:
- IDA, Thalassemias, SA, Chronic
Disease
- Decreased DNA Synth
- “Macrocytic” Megaloblastic
- Normal-Low Retics
- Diagnosis:
- Vitamin B-12, Folate Deficiencies
- Decreased Hgb Synth
- Production Defect:
- BM Injury, Decreased Erythropoietin,
Marrow infiltration- Normocytic, Normochromic
- Normal-Low Retics
- Diagnosis:
- Aplastic Anemia, Renal Disease,
Malignant Cells
- Aplastic Anemia, Renal Disease,
- BM Injury, Decreased Erythropoietin,
- RBCs loss from Circulation:
- Hemorrhage
- Normocytic, Normochromic
- High Retics
- Acute Blood Loss
- Hemorrhage
- RBC Survival Defect:
- Increased RBC Destruction
- Normocytic, Normochromic
- High Retics
- Hereditary-Acquired Hemolytic
Anemias
Lab Investigation for anemia begins W/?
CBC W/ Differential
CBC findings of Anemia?
Decreased Hgb
RBC Indices classify anemia
RBC morph abnormalities (can be diagnostic or suggest further testing).
WBCs and PLTs are normal-Increased in most anemias (Low in aplastic anemias).
Reticulocyte is useful in determining the?
Response to the anemia
RPI < 2
Inadequate BM response
RPI > 2
Good BM response
Iron Studies
Differentiate Microcytic/Iron Overload
SI, TIBC, SF
Increased Transferrin Synth
Increased TIBC
Low Iron
Low Ferritin
Iron Deficient state (IDA)
Decreased Transferrin Synth
Decreased TIBC
Increased Iron
Increased Ferritin
Iron Overload state (SA)
