Clinical and laboratory assessment of anaemia

Question 1

Anaemia is the reduction in ____ below the normal range and not reduction in _________

Answer 1

• Haemoglobin concentration

* reduction in the number of cells

Question 2

Clinical features of anemia

Answer 2

• Palor
• Fatigue and poor effort tolerance
• Dyspnoea and palpitations
• Dizziness, headache, irritability, and poor concentration
• GIT symptoms eg nausea, anorexia, and indigestion
• Menstrual abnormalities and impotence in male

Question 3

Physical findings in anemia

Answer 3

1. Palor: Not reliable indicator of anemia and should not be an indication of the degree of severity. The best places to look for anemia is conjunctiva, oral mucous membrane, nail bed and palmar creases
2. Cardiovascular feature: CNS compensates for decreased HB by increasing CO this results in tachycardia, wide pulse pressure, hyperdynamic precordium, soft- systolic ejection murmur from altered viscosity, and rapid flow and severe anemia may result in high output cardiac failure
3. Respiratory features: Tachypnoea

Question 4

Why should you try to avoid transfusion in chronic anaemic patients?

Answer 4

• Patients with chronic,slow-onset anaemia may have been adapted to living with extremely low Hg without severe anaemia . If these patients are transfused it may cause life-threatening cardiac failure thus must be transfused only when it is necessary. Transfusion must be slowly given with frequent diuretic furosemide to prevent fluid overload. Cobalamin deficiency where transfusion can lead to electrolyte transusion

Question 5

Causes of anemia

Answer 5

1. Decreased production of RBC and Hg in bine marrow

2. Destruction or loss of RBC that has left one marrow to enter circulation