Anemia Flashcards
Examination
Heart rate
Pallor: nailbeds, conjunctiva, oral mucosa
Jaundice
Signs of liver disease
Hemorrhoid so
Orthodontic changes
Strophic glossitis (smooth, shiny tongue)
Loss of proprioception and paresthesia’s (meglobalism, B12)
Evidence of chronic disease (renal/hepatic/GI/cancer)
Petechiae/Ecchymosis
Enlarged spleen
Anemia by Etiology
Blood loss
- acute
- chronic
Decreased production
- B12, folic acid, Fe deficiency
- infiltration of marrow by neoplasia
- aplastic anemia
Increased destruction
* hemolytic anemias
Microcytic
Fe deficiency
Thalassemia
Lead poisoning
Normocytic
Chronic disease
Renal disease
Infections
Acute blood loss
Macrocytic
B12, folic acid deficiency
Abnormal DNA synthesis
Macrocytic Anemia
*Deficiency of vitamin B12
*Deficiency of folic acid
Drugs affecting DNA synthesis
Inherited disorders of DNA synthesis
*Liver disease
Hypothyroidism
Hypopituitarism
Accelerated erythropoiesis (reticulocytes)
Hypogastric and aplastic anemia
Infiltrated bone marrow
Acute leukemia
Normocytic Anemia
Anemia of chronic dx Endocrine etiology Acute blood loss *Renal failure Hyperspace sim Neonatal anemia Hemolysis
Decreased Production RBC’s
Infiltration of marrow: neoplasia, myelofibrosis
Hyperplastic marrow: B12, folate, Fe deficiency
Aplastic/hypoplastic marrow - pure RBC aplasia: acquired acute RBC hypoplasia
Aplastic/hypoplastic marrow - familial: Diamond-Blackfan, Fanconi, Congenital pancytopenia
Aplastic/hypoplastic marrow (drugs/idiopathic): antibiotics, Dilantin, viral hepatitis
Aplastic/hypoplastic marrow - dose related: heavy metals, benzene, antimetabolites
Hemolytic Causes
Sickle cell Hereditary spherocytosis G6PD Pyruvate Kinase deficiency Microangiopathic disorders: DIC, Hemolytic uremic syndrome, TTP Mechanical hemolysis Paroxysmal Nocturnal hemoglobinuria
Intracorpuscular Defect: Hereditary
- hereditary spherocytosis
- hereditary elliptocytosis
- hemoglobinopathies
- thalassemias
- congenital dyserythropoietic anemias
- hereditary RBC enzymatic deficiencies
- rarer hereditary abnormalities
Intracorpuscular Defect: Acquired
- vitamin B12 and folic acid deficiency
- paroxysmal nocturnal hemoglobinuria
- server iron deficiency
Extracorpuscular Defect
- physical agents: burns, cold exposure
- traumatic: prosthetic heart valves, march hemoglobinuria, disseminated intravacular coagulation (DIC), graft rejection
- chemicals: drugs and venoms
- infectious agents: malaria, toxoplasmosis, mononucleosis, hepatitis, primary atypical pneumonia, clostridial infections, bartonellosis, leishmaniasis
- hepatic and renal disease
- collagen vascular disease
- malignancies: particularly hematologist neoplasia
- transfusion of incompatible blood
- hemolytic disease of the newborn
- cold hemagglutinin disease
- autoimmune hemolytic anemia Thrombotic thrombocytopenic purpura (TTP) and hemolytic-uremic syndrome (HUS)
Nutritional Etiologies
Iron deficiency
Vitamin B12 deficiency
Folate deficiency
Starvation and generalized malnutrition
Physical Etiologies
Trauma
Burns
Frostbite
Prosthetic valves and surfaces
Past Medical History
Ethnicity Black/tar colored stool Bleeding Fatigue easily Transfusions History of jaundice Females- menstrual flow Medications Pica - iron deficiency anemia Clay eating - bind with iron => deficiency OTC Diet Travel history History of illness (acute and chronic)
