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)