APPROACH TO ANEMIA

GAYANIRMALESSVARI.S.
FINAL YEAR MBBS PART -2
ANEMIA – def.

• Anemia is defined as a reduction in

hemoglobin concentration below the
normal level – due to : low oxygen
carrying capacity of blood .
 Etiological classification :

1. Anemia due to decreased production of RBC

Nutritional deficiencies: IDA,Megaloblastic anemia

2.Anemia due to increased destruction of RBC

(A) HEREDITARY :Sickle cell anemia ,thalassemia
(B) ACQUIRED :PNH,Malaria

3. Anemia due to acute blood loss : Hemorrhage ,GI

bleeding
MORPHOLOGICAL CLASSIFICATION:

1.Microcytic hypochromic anemia

2.Macrocytic anemia

3.Normocytic normochromic anemia

Microcytic hypochromic :
Microcytic – reduced RBC
size ( MCV <87 fl )
Hypochromic – red color
decreased ( MCHC<30
gm/dl )
*IDA
*THALASSEMIA
*SIDEROBLASTIC
ANEMIA
PARAMETER MICROCYTIC HYPOCHROMIC ANEMIA

1 .MEAN CELL VOLUME LOW

2.RED CELL ON BLOOD SMEAR MICROCYTIC HYPOCHROMIC

3.SERUM IRON LOW

4.SERUM FERRITIN LOW

5.TIBC INCREASED

6.STORAGE IRON IN MARROW ABSENT

7.HEMOGLOBIN ELECTROPHORESIS NORMAL

8.IRONIN ERYTHROBLAST ABSENT

9.SERUM SOLUBLE TRANSFERRIN RECEPTOR INCREASED

MACROCYTIC ANEMIA
Abnormally large RBC
Central pallor increased
(MCV>100 fl )
( MCHC =30-35 gm / dl )

*MEGALOBLASTIC- vit –B12 defIciency

* NON MEGALOBLASTIC – Alcoholism,hemolytic
anemia
NORMOCYTIC
NORMOCHROMIC
RBC- size and color-
normal ( MCV= 80-100fl)
( MCHC=30-35 gm /dl )

• Reticulocyte increased – recent blood loss

• Reticulocyte decreased – Aplastic anemia