ANEMIA – ANAIMIA – WITHOUT BLOOD OTHER LAB TEST: IRON STUDIES (DIAGNOSIS MICROCYTIC,
HYPOCHROMIC), URINALYSIS (HEMOGLOBINURIA,
REDUCTION IN HGB CONTENT OF BLOOD THAT CAN BE UROBILINOGEN, HEMATURIA/HEMOSIDERIN), FECALYSIS CAUSED BY A DECREASE IN THE RBCCOUNT (OCCULT BLOOD AND PARASITES), CHEM STUDIES (SERUM RELATIVE ANEMIA HAPTOGLOBIN, LACTATE DEHYDROGENASE), DIRECT RBC MASS IS NORMAL – INCREASED PLASMA VOLUME ANTIGLOBULIN TEST (DIFF AUTOIMMUNE ANEMIAS) RETICULOCYTE COUNT NORMAL; CLASSIFICATION OF ANEMIA: NORMOCYTIC/NORMOCHROMIC ANEMIA MORPHOLOGIC: ABSOLUTE ANEMIA BASED ON MCV: EXTREMELY IMPORTANT TOOL AND IS KEY RBC MASS IS DECREASED, BUT PLASMA VOLUME IS NORMAL MICROCYTIC ANEMIA: MCV <80FL W/ SMALL RBC <6UM MACROCYTIC ANEM: MCV >100FL W/ LARGE RBC >8UM THIS IS INDICATIVE OF A TRUE DECREASE IN ERYTH. AND HGB NORMOCYTIC ANEM: MCV 80-100FL 6-8UM DIAMETER PHYSICAL EXAM OF PX WITH ANEMIA BASED ON RETICULOCYTE COUNT: CATEGORIES SKIN – PETECHIAE EYES – PALLOR, JAUNDICE, HEMORRHAGE DECREASED/INEFFECTIVE RBC PROD. (DEC. RETICO #) MOUTH – MUCOSAL BLEEDING -SUBGROUPS:NORMOCYTIC, MICROCYTIC, MACROCYTIC EXAM SEARCH STERNAL TENDERNESS, LYMPHADENOPATHY, -EXCESSIVE RBC LOSS (INCREASED RETICU COUNT) CARDIAC MURMURS/ARRHYTHMIAS, SPLENOMEGALY & BASED ON RDW: HELP DETERMINE CAUSE OF ANEMIA HEPATOMEGALY WHEN USED IN CONJUCTION WITH THE MCV: JAUNDICE – DUE TO INCREASED RBC DESTRUCTION W/C MCV CATEGORIES CAN ALSO BE SUBCLASSIFIED OF RDW SUGGEST A HEMOLYTIC COMPONENT TO ANEMIA. -HOMOGENEROUS (NORMAL RDW), HETEROGENEROUS CLASSIC SYMPTOMS – FATIGUE AND SHORTNESS BREATH (INCREASED/HIGH RDW) MODERATE ANEMIA (HGB 7-10 G/DL) PALLOR OF CONJUCTIVAE AND NAIL BEDS, DYSPNEA, VERTIGO, HEADACHE, MUSCLE WEAKNESS SEVERE ANEMIA (HGB <7G/DL) SAME AS MODERATE BUT W/ TACHYCARDIA, HYPOTENSION AND SYMP WITH VOLUMELOSS MECHANISM OF ANEMIA INEFFECTIVE ERYTHROPOIESIS – DEFECTIVE PRODUCTION OF ERYTHROID PRECURSOR CELL ASSOCIATED WITH MEGALOBLASTIC ANEMIA – IMPAIRED DNA SYNTHESIS DUE TO VIT B12 / FOLATE DEFIC. THALASSEMIA – DEFIC. GLOBIN CHAIN SYNTHESIS SIDEROBLASTIC ANEMIA–DEFIC. PROTOPORPHYRIN SYNTHE. INSUFFICIENT ERYTHROPOIESIS – DECREASE IN NUMBER OF ERYTHROID PRECURSORS, DECREASED RBC PROD. & ANEMIA ASSOCIATED WITH: IRON DEFIC – INADEQUATE INTAKE, MALABSORPTION, EXCESSIVE LOSS FROM CHRONIC BLEEDING EPO DEFIC. – RENAL DISEASE LOSS OF ERYTHROID PRECURSOR – APLASTIC ANEMIA, PURE RED CELL APLASIA INFILTRATION OF BM SPACE LEUKEMIC CELLS & NON- HEMATOPOIETIC CELLS – METASTATIC TUMORS, GRANULOM. BLOOD LOSS AND HEMOLYSIS ACUTE – CHARACTERIZED BY SUDDEN LOSS OF BLOOD RESULTING FROM TRAUMA/OTHER SEVERE FORMS OF INJUR. CHRONIC – BY GRADUAL, LONGTERM LOSS OF BLOOD, CAUSED BY GASTROINTESTINAL BLEEDING INCREASED HEMOLYSIS RESULTS IN A SHORTENED RBC LIFE. INTRINSIC DEFECT – RBC MEMBRANE, ENZYME SYSTEMS,HGB EXTRINSIC DEFECT – IMMUNE (ANTIBODY MEDIATED)/NON- IMMUNE (MECHANICAL FRAGMENTATION) LAB DIAGNOSIS OF ANEMIA: CBC, RETICULOCYTE COUNT (BM ABILITY TO INCREASE RBC PROD IN RESPONSE TO AN ANEMIA), PERIPHERAL BLOOD FILM EXAM (ASSESSMENT RBC DIAMETER, SHAPE, COLOR), BONE MARROW EXAM (PX W/ UNEXPLAINED ANEMI, W/ W/OUT OTHER CYTOPENIAS)