HEME 02-05: Anemia

Question 1

What do the signs and symptoms associated with anemia depend on? (2)

Answer 1

• rate of development
• age

Question 2

What does NOT always correlate with degree of anemia? (2)

Answer 2

• cardiovascular status – older patients are more sensitive to lower Hb levels
• severity of symptoms – asymptomatic (mild anemia in younger patients)

Question 3

What are the signs and symptoms specific to ACD/AI?

Answer 3

symptoms of underlying disorder often overshadow anemia symptoms

Question 4

What are the signs and symptoms associated with anemia?

Answer 4

symptoms:

• decreased exercise tolerance
• fatigue, weakness
• dizziness, vertigo
• irritability
• palpitations
• shortness of breath, chest pain
• nausea, anorexia
• menstrual problems, loss of libido

signs:

• tachycardia
• pale appearance – most prominent in conjunctivae
• depression, decreased mental acuity
• increased intensity of some cardiac valvular murmurs

Question 5

What is required for anemia diagnosis?

Answer 5

complete blood count (CBC)

• hemoglobin (Hb)
• mean corpuscular volume (MCV)
• total reticulocyte count

Question 6

Complete Blood Count (CBC)

Hemoglobin (Hb) Levels

Answer 6

anemia:

• male: Hb < 130 g/L
• female: Hb < 120 g/L

Question 7

Complete Blood Count (CBC)

What is mean corpuscular volume (MCV)?

Answer 7

average RBC size per volume

Question 8

Complete Blood Count (CBC)

Mean Corpuscular Volume (MCV) Levels

Answer 8

• MCV = 80-100 fL: normal
• MCV < 80 fL: smaller than normal = microcytic anemia = IDA, thalassemia
• MCV > 100 fL: larger than normal = macrocytic = vitamin B12/folate deficiency

note: may have combination of IDA + folate deficiency that leads to normal MCV

Question 9

Complete Blood Count (CBC)

What is total reticulocyte count?

Answer 9

indirect assessment of new RBC production that reflects how quickly immature RBCs (reticulocytes) are produced by bone marrow and released into blood

Question 10

Complete Blood Count (CBC)

Total Reticulocyte Count Levels

Answer 10

• normal: 1%
• low: impaired RBC production – iron deficiency, B12 deficiency, malnutrition, renal insufficiency, malignancy
• high: acute blood loss or hemolysis

Question 11

What information does a peripheral blood smear provide? (3)

Answer 11

• RBC characteristics (size, shape, size of central pallor) and other blood cells
• functional status of bone marrow and defects in RBC production
• clues for diagnosis – sickling of RBCs in sickle cell anemia, megalocytes and segmented neutrophils in megaloblastic anemia