Introduction to anemia

Question 1

What is the definition of anemia?

Answer 1

Anemia is a hematologic condition in which there is quantitative deficiency in circulating haemoglobin depending upon the patient’s age and sex.

Question 2

What is the physiologic result of low circulating Hb?

Answer 2

● Reduce capacity of blood to carry the oxygen
● Reduced number of RBCs
●Reduced content of Hb in RBCs

Anemia associated with low hematocrit (HCT) value

Question 3

What are the criteria for anemia?

Answer 3

Hemoglobin:
-Male: Hb < 13.5 g/dL. Female: < 11.5g/dL
- 2 years to puberty : 11.0 g/dL
- Newborn: 14.0 g/dL is taken as a lower limit because of high Hb.

Question 4

What are the criteria for anemia?

Answer 4

Hemoglobin:
-Male: Hb < 13.5 g/dL. Female: < 11.5g/dL
- 2 years to puberty : 11.0 g/dL
- Newborn: 14.0 g/dL is taken as a lower limit because of high Hb.

Question 5

What hemoglobin are consist of?

Answer 5

Hemoglobin consists of heme (iron & protoporphyrin) and globin (2 polypeptide chains).

Question 6

Where are the sites of production of haem and globin in the cells?

Answer 6

●Haem in mitochondria
●Globin in polyribosomes

Question 7

Explain globin synthesis?

Answer 7

● Hemoglobin consists of 2 globin protein mainly 2 alpha and 2 beta chains in adult.
● Globin chain is synthetized in the ribosomes of rbc precursor.
● Beta globin is located on the short arm of chromosome 11
● Alpha globin on the short arm of chromosome 16
●Alpha cluster has 141 amino acids, and they are essential for life. They are also inherited 2 from each parent.
● Beta cluster which in chromosome 11 contain Beta,gamma and sigma chains and it’s also has 146 amino acids, and they are essential for life. Inherited one gene from each parent.

Question 8

State types of hemoglobin and its structure.

Answer 8

At birth:-
-Hb F : Alpha 2 & Gamma 2 globin chains

In adult:-
-HbA : Alpha 2 & Beta 2 globin chains
HbA2: Alpha 2 & Delta 2 globin chains

Question 9

Explain 2 types of classification in anemia?

Answer 9

Anemia can be classified according to:
1.Morphology of RBC
- Normocytic, normochromic anemia. (normal MCV & MCH)
• Etc: acute blood loss, hemolysis
-Macrocytic, normochromic anemia ( high MCV)
• Etc: deficiency of vit B12/ folic acid
-Microcytic, hypocromic anemia (low MCV & MCH)
•Etc: iron deficiency anemia, sideroblastic state, anemia of chronic disease.

2. Etiology
   -Increase of rbc loss (bleeding, hemorrhage)
   -Decreased or defective cell production ( iron, B12, folate def, bone marrow disorder)
   -Destruction of RBC ( immune hemolytic,thalassemia, mechanical)

Question 10

Explain 2 types of classification in anemia?

Answer 10

Anemia can be classified according to:
1.Morphology of RBC
- Normocytic, normochromic anemia. (normal MCV & MCH)
• Etc: acute blood loss, hemolysis
-Macrocytic, normochromic anemia ( high MCV)
• Etc: deficiency of vit B12/ folic acid
-Microcytic, hypocromic anemia (low MCV & MCH)
•Etc: iron deficiency anemia, sideroblastic state, anemia of chronic disease.

2. Etiology
   -Increase of rbc loss (bleeding, hemorrhage)
   -Decreased or defective cell production ( iron, B12, folate def, bone marrow disorder)
   -Destruction of RBC ( immune hemolytic,thalassemia, mechanical)

Question 11

In red cells indices, what does it mean by MCV, MCH and MCHC?

Answer 11

-MCV(Mean corpuscular volume): define the size of the rbc.

-MCH(Mean corpuscular hemoglobin): quantities the amount of hemoglobin per red blood cell.

MCHC(Mean corpuscular hemoglobin concentration): quantities the amount of hemoglobin per unit volume.