Evaluation of a patient with anaemia Flashcards
Anaemia :
Introduction
• When _____ content is less than expected for ___________________ taking into consideration ________,_________, and __________ status
Hb
the age and sex of an individual
European values for PCV(%)
_____ ± ___
_____ ±____
• WHO criteria for anaemia
<_____ g/dl (M)
<____gdl (F)
42 ± 7
46±5
13;12
Classification of RBC Anaemia
• Morphologic
Based on red cell indices -_____,______,_______
•_________,_____,________
Degree of haemoglobinization - _______,_________
MCV MCH MCHC
Normocytic -Microcytic -Macrocytic
Normochromic -Hypochromic
Classification of RBC Anaemia
Based on red cell maturation - _________,____________
Megaloblastic -Normoblastic
Classification of Anaemia - Aetiology
• _________ Anaemia
• Red cell ___________ (________)
• Reduced red cell __________
• ________
• Other- Anaemia of ___________
-Miscellaneous
Nutritional
destruction;haemolysis
production
Blood loss
chronic disorders
Classification- Aetiology
• Nutritional anaemias
-_______ deficiency
-_______ deficiency
- _____ deficiency
Iron deficiency
-Folate deficiency
- B12 deficiency
Classification- Aetiology
• Bloodloss
- GI- ________,________,_______,______,_____,_______
- Genito urinary- ________,________
Hookworm infestation, PUD menorrhagia bleeding
oesophageal varices gastric tumors colonic ca,
menorrhagia , schistomiasis,
Classification- Aetiology
• Bloodloss
Respiratory -massive ________ (from __________________ diseases)
- Bleeding disorders eg _________
- ________ blood loss from trauma eg RTA
hemoptysis
suppurative lung
Haemophilia
Acute
Classification- Aetiology
• Redcelldestruction/haemolysis(Inherited)
- Haemoglobinopathies
Qualitative- __________
Quantitative – ____________
-Red cell membrane defects- hereditary __________ , hereditary ________________
-Enzyme defects- _________, ___________ deficiency
Sickle cell disease; Thalassemias
spherocytosis; elliptocytosis
glucose 6 phoshate dehydrogenase ; pyruvate kinase
Classification of Anaemia based on Aetiology
Red cell destruction-Acquired
-Immune( antigen antibody mediated)
(i) Auto immune-caused by ———————————————
(ii)Alloimmune- Haemolysis occurs due to reaction between ______________________________
(iii)Drug associated _________,________,_________,_________ also herbal medications
antibody production by the body against its own red cells. Autoantibodies may be of IgG, IgM, or IgA class.
red cells (antigen) from one individual with antibody from another individuale. e.g Haemolytic transfusion reaction Haemolytic disease of newborn—Rh or ABO
penicillin, ampicillin quinidine, rifampicine.methyldopa)
Classification of Anaemia based on Aetiology
Red cell destruction -Acquired
-Red cell fragmentation syndromes e.g ___________,_________,________,____________
-Infections e.g ________,_______ infections leading to septicaemia,
-Chemical and physical agents- especially drugs, industrial/domestic substances, burns
- Liver and renal disease- especially with uraemia
Disseminated intravascular coagulation
Malignant hypertension
Pre - eclampsia/HELLP(haemolysis, elevated liver enymes, low platelet count)
Malaria, bacterial
Classification of Anaemia- Aetiology
• Reduced production
Usually as part of ______________
bone marrow failure
Investigations in Anaemia
Baseline:
• ____________
• ___________ count –↑ in hemolysis, reduced or unchanged in marrow supression in response to the anaemia
• ___________
• ___________
• ___________-cellmorphology
Full blood count
Reticulocyte
ESR
Red cell indices
Blood film
Definitive treatment
• Treat the underlying cause- Remember anaemia is not a diagnosis on its own .
• Blood transfusions required if anaemia is ___________ or the patient is in anaemic _____________
symptomatic
heart failure
