L1: Anemia - Intro Flashcards
Formation of RBCs
- Timing
Formation of RBCs
- Site
Formation of RBCs
- Stages
Formation of RBCs
- changes in Nucleus, Size, Hb
Formation of RBCs
- Factors Affecting erythropoiesis
Factors Affecting erythropoiesis
- Metals
- Iron → Hb
- Copper → Heme
- Cobalt
Factors Affecting erythropoiesis
- Vitamins
Factors Affecting erythropoiesis
- Hormones
- Thyroid gland → T3, T4
- Anterior pituitary gland → GH
- Adrenal gland → CTS
Factors Affecting erythropoiesis
- Proteins
They are essential for formation of the globin part of Hb
Factors Affecting erythropoiesis
- EPO
A protein substance secreted by the kidney & stimulates erythropoiesis
Size of Hb
1/3 of RBC mass
Structure of Hb
Types of Hb
Types of Hb
- Hb A
Types of Hb
- Hb F
Types of Hb
- Hb A2
Fate of Hb
Life span of RBCs
120 Days
Def of Anemia
Types of Anemia
Most common anemia in Egypt
Iron deficiency anemia
Most common acute hemolytic anemia in Egypt
G6PD deficiency
- Most common chronic)hemoly tic anemia in Egypt
- Only microcytic hypochromic chronic hemolytic anemia
Thalassemia
CP of Anemia
Causes of Anemia
Causes of Microcytic Anemia
Causes of Microcytic Anemia
- Defective globin chain
- Thalassemias
Causes of Microcytic Anemia
- Defective heme synthesis
- Anemia of chronic disease
- Iron deficiency (late)
- Lead poisoning
Causes of Normocytic Anemia
Causes of Normocytic Anemia
- Nonhemolytic (low reticulocyte index)
- Iron deficiency (early)
- Anemia of chronic disease
- Aplastic anemia
- Chronic kidney disease
Causes of Normocytic Anemia
- Hemolytic (high reticulocyte index)
Causes of Normocytic Anemia
- Intrinsic Hemolytic
Intrinsic Hemolytic Causes of Normocytic Anemia
- Membrane Defects
- Hereditary spherocytosis
- Paroxysmal nocturnal hemoglobinuria
Intrinsic Hemolytic Causes of Normocytic Anemia
- Enzyme Deficiencies
- G6PD deficiency
- Pyruvate kinase deficiency
Intrinsic Hemolytic Causes of Normocytic Anemia
- Hemoglobinopathies
- Sickle cell anemia
- HbC disease
Extrinsic Hemolytic Causes of Normocytic Anemia
- Autoimmune
- Microangiopathic
- Macroangiopathic
- Infections
Causes of Macrocytic Anemia
Causes of Macrocytic Anemia
- Megaloblastic
Causes of Macrocytic Anemia
- Non-Megaloblastic
INVx for Anemia
- CBC (PBE)
- BM Aspiration
- Cut-off level of Hb & Hct for anemia
- Coomb’s Test
- Reticulocytic count
INVx for Anemia
- CBC (PBE)
HCT
MCV
MCH
MCHC
INVx for Anemia
- BM Aspiration
….
INVx for Anemia
- Cut-off level of Hb & Hct for anemia
INVx for Anemia
- Coomb’s Test
Technique of Coomb’s Test
Interpretation of Coomb’s Test
Presence of antibodies against RBCs → Immune anemia
INVx for Anemia
- Reticulocytic Count
Reticulocytic Count in Anemia
- Technique
- Measuring the percentage of all RBCs that are reticulocytes
Reticulocytic Count in Anemia
- Importance
- It is an index for bone marrow activity
Reticulocytic Count in Anemia
- Normal Value
1 - 2 % of RBCs count
Reticulocytic Count in Anemia
- Decreased Result
- Anemia due to decreased production of red cells
- It is < 3% and frequently < 1.5%
Reticulocytic Count in Anemia
- Elevated Result
Hyperactive bone marrow (Increased Erythropoiesis)
- Hemolysis
- Blood loss
- Anemia under treatment
- Recovery from BM suppression
Reticulocytic Count in Anemia
- Reticulocyte Index