Ane mia

•
Anemia is
defined as Reduction of Total Circulating
Red Cell mass below normal limits .

Anemic Hb
ranges of
Severity
•
:
:

|
( Hb )
Cage)
Children (0.5-4) <
11g / de
lil Mild : 9.5 -
13
gldl

children (5-12) < 11

-5g 1dL
(often no
signs )
child " " " ' " ' "
"" ciii Moderate : 8- 9.5

Adult
13g 1dL
<
( symptomatic )
men

Nonpregnant
< 12
gldl
(Iiis Severe : < 8.0

Pregnant gldl
< 11
women

(
life threatening )
-

symptoms
(A) Acute : cis shortness of Breath

cii ,
Organ failure
iii. Shock

(B) Chronic :( is General -

Fatigue Irritability
Palpitations Sleep disturbance
Dizziness Anorexia

Syncope Amenorrhea
 iii ,
Haemolysis -
Skeletal Abnormalities

Growth Retardation

Jaundice

Gallstones

ciiii
Defective Erythropoiesis -
Endocrine Failure

Heart Failure .

Signs :

d) Pallor of skin & Mucous membranes ,

nail beds &

palpebral conjunctiva .

iii
Tachycardia with Wide Pulse Pressure .
Ejection
systolic murmur .

Iii , Cardiac dilatation ,

signs of Cardiac Failure

in Edema
 Classification :
( Based on Mcu )

(A) Micro
cytic (3) Norm
ocytic (c) Macro
cytic
( µm 3)
's
MCU C 80 ( MCU = 80 -100 µm ) ( MCU > 100 µm3 )
I
* if

in Iron deficiency ii.

Hemolytic
ci , Folate
deficiency
Anemia
Anemia Anemia
cii , Vit 1312 def .

Anemia of Blood
Iii ,
ciii Anemia of Anemia
Chronic Disease Loss

iii. is Sickle Cell Disease

ciii , sideroblaslic
Anemia

in Thalassemia

A. Microcytic Anemia
• Anemia with MCU < so µm3
•
Micro cytic anemia are due to decreased production
of Hemoglobin .

Is

Microcytosis is due to an extra division which

occurs to maintain Hb Concentration .

•
Micro cytic Anemia includes :

(a) Iron
deficiency Anemia (c) Sideroblastic Anemia
(b) Anemia chronic
of Disease (d) Thalassemia .
 Iron Deficiency Anemia

•
Due to decreased level of Iron .

Iron He A Herne I Hb Micro

cylic Anemia
•
→ → →

Most lack
• common
type of Anemia ; of Iron is

the most common nutritional

deficiency in the world ,

affecting approx 43rd of Population .

Iron Metabolism :

duodenum
•

Absorption occurs in .

Enterocytes have

heme ( meat derived )

-
and non -
heme ( plant-derived )
DMTI
transporters .
Heme form is
readily absorbed .

Enterocytes transport iron across the cell membrane

Ferro
into blood via pork 'm .
 •

Transferrin transport iron in blood and delivers it

to liver and bone marrow for storage .

•
Stored intracellular iron is

bound ferritin which

to ,

prevents iron from forming

free radicals via the
Fenton reaction .

so-so

Causes :

•
Iron deficiency is
usually caused
by Dietary lack or

blood loss .

cis
Infants -

Breastfeeding ( Human milk is low in Iron )

iii. Children - Poor diet

His Adult ( 20 -50

yrs )
-

Peptic ulcer disease in Males

Menorrhagia or
Pregnancy in

Females
in
Elderly -
Colon
polyp / carcinoma

Hookworm duodenal e)
( Ancylostoma
(v ) Other causes -
Malnutrition , Malabsorption & Gast redo
my
-

.
 Detailed
Etiology

stages of Iron
deficiency :

cis
storage iron is
depleted A TIBC ,
I Ferritin

(in serum iron is depleted A Serum iron

, ,

I % Saturation
iiis Norm
(
ocytic Anemia Bone marrow makes leis RBC
( but normal size )

( in makes
the
crocylic Anemia Bone smaller
-

→
marrow

& Fewer RBCs .

 Clinical Features :

Dye to :

Pallor
( is Anemia -
Weakness ,
fatigue ,
dyspnea ,
Angina ,

in Epithelial tissue
change -
(a) koiloncychia
(b) Nails ( thin ,
brittle )

(c)
Tongue -

Atrophy of Papillae
(d) Plummer -
Vinson
Syndrome
Iii , Pica

in Recurrent infections .

Laboratory findings :

Serum ( < 50µg 1dL ) ( Normal

(1) iron A,
60-140
peg 1dL )

(2) Total iron -

binding capacity ( TIBC ) AH ( Normal :

250
-450µg 1dL

(3) % Saturation µ, ( about 10% ) ( Normal cis 33% )

Serum ferritin Reflects

(4) -
iron
storage in

liver I.
macrophages and ( clang 1mL )

( Normal 30-250 /
ng my
 Treatment :

Correction of
( is
Underlying cause .

ciii Correction of Fe
deficiency ( Supplemental iron

Ferrous sulphate )

C
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