Anemias

Question 1

Normocytic normochromic anemia with NL RDW

Answer 1

Can be seen in acute GI bleeds, chronic conditions

Hb↓
Hct ↓
RBC ↓
MCV=NL
MCHC=NL 
RDW=NL

Next step dictated by underlying cause. Can rule out other anemias.

Question 2

Microcytic hypochromic anemia with elevated RDW

Answer 2

Iron deficiency anemia. Can be seen in erosive gastritis, menorrhagia

Hb↓
Hct ↓
RBC ↓
MCV=↓
MCHC=↓
RDW=↑

Next step: Get a ferritin (iron levels)

Question 3

Microcytic hypochromic anemia with NL RDW

Answer 3

Alpha beta or beta thalassemia minor (seen in mediterranean, asian, middle eastern ancestrys, etc.

Hb↓
Hct ↓
RBC ↑
MCV=↓
MCHC=↓
RDW=NL

Next Step: Hemoglobin electrophoresis, get genetic testing before pregnancy

Question 4

Macrocytic normochromic anemia with elevated RDW

Answer 4

B12 and folate deficiency

Hb↓
Hct ↓
RBC ↓
MCV=↑
MCHC=NL
RDW=↑

Next Step: Serum vitamin b12 and RBC folate

Question 5

Drug induced macrocytosis usually without anemia

Answer 5

Excessive drinking common etiology. Certain medications (Antiepileptics ex. phenytoin).
Hb=WNL
Hct=WNL
RBC=WNL
MCV=↑
MCHC=WNL
RDW=WNL

Next step: Reversible when condition is treated such as excessive alcohol intake.