approach to a diagnosis of anemia Flashcards
what are the mechanisms of anemia ?
increased destruction
impaired synthesis
what are anemias classified based upon ?
cause
morphological abnormalities
underlying pathophysiology
what are the morphological abnormalities seen in anemia ?
microcytic/hypochromic
macrocytic/normochromic
normocytic/normochromic
what are the types of macrocytic anemias ?
megaloblastic
non-megaloblastic (normoblastic)
what could be the causes of megaloblastic anemia ?
b12 deficiency
folic acid deficiency
congenital dyserythropoeitin anemia
what does a leucoerythroblastic reaction mean ?
denotes the presence of both the precursors of white blood cells and red blood cells on a blood film
when do we see a leucoerythroblastic reaction ?
in severe blood loss and severe infection and acute hemolysis
how would you diagnose a case of undiagnosed anemia ?
by describing the size of the red blood cells
when do we see microcytic hypochromic anemia ?
in iron deficiency
thalassemia
lead poisoning
sideroblastic anemia
when do we see normocytic normochromic anemia ?
blood loss anemia of chronic disease renal disease mixed deficiencies bone marrow failure hemolytic anemias
when do we see macrocytic anemia ?
in megaloblastic and non megaloblastic forms : b12 deficiency folate deficiency congenital dyserythropoeitin anemia liver cirrhosis alcohol
how does the body react to anemia?
- increased cardiac output
- redistribution of blood flow between organs
- increased capacity of haemoglobin to release oxygen to the tissue ( shift to the right )
what are the clinical features of anemia determined by ?
severity of the anemia
speed of onset of he anemia
patients with co-morbidities
which type of anemia may cause neurological deficits ?
b12 deficiency
how could we differentiate between bone marrow infiltration and haemolysis ?
reticulocytes would be decrease in BMF and increased in haemolysis
what are the causes of high reticulocyte count in anemic patients?
chronic haemolysis
after acute haemorrhage
if the reticulocyte count doesn’t rise in an anemic patient what could this suggest ?
impaired bone marrow function
or lack of erythropoietin
what is the special reticulocyte stain
supravital stain - billiant cresyl blue or new methylene blue
what would be the investigations for detecting anemia
full CBC blood film examination reticulocytes haematinics - serum b12, folate and iron studies biochemistry panel
what can we do for a patient that old age and has anemia with no underlying cause ?
colonoscopy
what is the main managment of anemia ?
treat the underlying cause
what stain vcan be used to see iron stores ?
Prussian blue
