Anemia

Question 1

General Characteristics of Anemia

Answer 1

• Decreased oxygen-carrying capacity of the blood
• ↓ RBC Count
• ↓ Hemoglobin (Oxygen consumption
• Decreased oxygen carrying of blood -> tissue hypoxia
• Signs and symptoms of anemia are due to tissue hypoxia and/or the
compensatory responses of the cardiovascular system to the hypoxia)

Question 2

Anemia: Signs/Symptoms

Answer 2

-Fatigue
-Pallor
-Dyspnea
-Dizziness
-Weakness
-Headache
-Tinnitus
-Irritability
-Amenorrhea
-Palpitations
-Loss of Libido
-GI Complain

Question 3

Anemia: Lab Findings

Answer 3

Complete Blood Count (CBC)
• RBC Count: 3.5-5.5 mil (F)/4.3-5.9 mil (M)
• Hemoglobin: Mild: 10-12/Moderate: 6-10/ Severe: <6
• Hematocrit

• Peripheral blood smear: Most important single test in diagnosis of anemia
• Reticulocyte count: 0.5-1.5%
RBC Indices
-MCV (Size), MCH, MCHC (Color)
• RDW: Earliest indicator
• Bone marrow aspiration and biopsy
• Cellularity, cell morphology, iron reserves

Question 4

Etiologic Classifications of Anemia

Answer 4

Blood loss, Deficient Erythropoiesis, excessive RBC destruction

Question 5

Hypochromic-Microcytic Anemia

Answer 5

IDA, Sideroblastic (iron utilization), ACD (iron reutilization)

Question 6

Normochromic-normocytic anemia indicates:

Answer 6

Renal disease (aplastic anemia), endocrine failure (myeloplastic anemia)

Question 7

Megaloblastic/macrocytic anemia is found in what kinds of anemia?

Answer 7

-B12/Folate

Question 8

Intrinsic RBC defects

Answer 8

-RBC membrane alterations: hereditary spherocytosis
-Disorders of red cell metabolism: G6PD deficiency
-Defective hemoglobin synthesis: Sickle cell, thalassemia

Question 9

Extrinsic RBC defects

Answer 9

Traumatic hemolytic anemia, hemolysis due to infectious agent, anemia d/t immunologic abnormalities

Question 10

Acute Post-Hemorrhagin Anemia: Etiology

Answer 10

-Traumatic/spontaneous rupture of major blood vessel
-Erosion of artery by lesion
-Failure of hemostasis
-Ex. Car accidents, falls, bleeding during child birth, bleeding disorders

Question 11

Chronic Post-Hemorrhagic Anemia: Etiology

Answer 11

-Prolonged moderate blood loss
-GI tract lesion: ulcers, gatritis, GERD, colorectal cancer, crohns/Ulcerative colitis, polyps, hemorrhoids
-Urologic: Bladder cancer
-Gynecologic site: Heavy menses (hormone imbalance), uterine fibroids, endometriosis, PCOS, endometrial cancers, PID

Question 12

Acute PH Anemia: Clinical Findings (Symptoms)

Answer 12

-Faintness
-Dizziness
-Thirst
-Sweating
-Weak/rapid pulse
-Rapid respiration
-Orthostatic hypotension

Question 13

Chronic PH anemia: Clinical Findings

Answer 13

-Same for iron deficiency: Decreased Ferritin

Question 14

Acute pH anemia: Lab Findings

Answer 14

-During/immediately following hemorrhage: RBC, Hb, and Hct are normal
-Tissue fluid will enter circulation->dilution->drop in RBC count, Hb and Hct (normocytic)
-Neutrophilic leukocytosis & thrombocytosis within hours
-Several days: Polychromatophilia (reticulocytes), slight macrocytosis (iron deficient), occasional normoblasts, immature WBCs

Question 15

Chronic pH anemia: Lab Findings

Answer 15

IDA (Hypochromic + microcytic)

Question 16

What is the most important test for anemia?

Answer 16

Peripheral blood smear

Question 17

Earliest indicator of Anemia

Answer 17

RDW