CLASSIFICATION AND GENERAL FEATURES OF ANEMIA

Question 1

INTRODUCTION

Answer 1

Definition- Anemia can be defined as a reduction in any of the parameters

• Hb concentration
• number or red blood cells
• in the oxygen carrying capacity of the blood, insufficient to meet the individual’s physiologic needs

Anemia is not a disease rather an expression of an underlying disorder or disease
Anemia will only occur when the loss of rbc exceeds the max capacity of the bone marrow for rbc production (as the bone marrow can increase its capacity up to 5 times in increased rbc loss)

Question 2

CONDITIONS ASSOCIATED WITH ANEMIA

Answer 2

Nutritional Deficiency (iron, vit b12, folate def)

External or Internal Blood loss ( Acute as in; ectopic pregnancy, pph, menorrhagia, surgeries, haematuria or Chronic as in; GIT cancers PUD Gyne Cancers Helmenthiasis

Increased destruction if RBC’s (as in Enzymopathies e.g G6pd Def or Haemoglobinopathies e.g thalassemia, SCD

Ineffective or Reduced production of RBC’s (Bone marrow failure e.g Aplastic anemia, Bone marrow infiltration e.g leukemia, lymphomas and carcinomatosis.

Infections

Bone marrow suppression by toxin, chemicals or radiation

Abnormal HB synthesis

Bone Marrow infiltration by Malignant cells

Question 3

GRADING

Answer 3

Graded into mild, severe and moderate based on HB concentration

Using Hb concentration (G/DL)
In children & Women 
Normal >/= 12.0
Mild— 10-11.9
Moderate— 8.0-10.9
Severe— = 8.0

In Men
Normal >/= 13.0
Mild— 10.0-12.9
Moderate— 8.0-10.9
Severe— = 8.0

Question 4

CLASSIFICATIONS

Answer 4

Aetiology (prev slides)

MORPHOLOGICAL CLASSFICATION

• Microcytic anemia (Mcv < 76fl, smaller wider and more platelets) found in Iron def, thalassemia and anemia of chronic diseases
• Macrocytic Anemia(Mcv > 96fl, larger and oval in shape) folate and B12 def, hypothyroidism
• Normocytic anemia(Normal Mcv within 76-96fl) acute blood loss, aplastic anemia, early ACD( anemia of chronic disease)

Question 5

DIAGNOSIS OF ANEMIA

Answer 5

Clinical history
Physical examination 
Laboratory investigations 
Fbc
Pcv, Hb, Retic count, Mcv, Mch, Mchc and Rdw(red cell distribution width)
Esr
Bm studies
Coombs test 
Serum erythropoietin
Serum folate and B12
Iron metabolism studies
Wbc
Platelets