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Detection of anemia

Co-ordinator:Dr.Nitin Raithatha
Represented by:Jay
patel,Alfaz lakhani
Batch:26-50
Clinical
Diagnosis
• History
• Clinical examination
• Hematological
Investigation
• Other Investigation
Clinical symptoms

Easy fatiguability
Palpitation
Shortness of breath
Decrease work or exercise
tolerance
Acute and Chronic
• Acute • Chronic
– Fatiguability – Koilonychia
– Breathlessnes – Angular
s Cheilosis
– Palpitation – Fainting
– Hypotension – Compenseted:
– Tachycardia may have
pulse and BP
normal
History
Age and Parity: Elderly
and multifetal gestation
are more prone

Bruises, Petechial
Hematuria suggest hemmorhage suggest
hemolytic anemia platelet disorder
History
• History of blood loss from bleeding
gums or bleeding piles.
• Family history: Hereditary hemolytic
anemia,bleeding disorder
• Dietry history: with respect to folic
acid intake
• Personal history:
• Menstrual history: Heavy blood loss
• Obstretic history:abortion,Child birth,
Hemmorhage
Pallor
Conjuctival pallor
Koilonychia
Smooth Tongue
Angular Cheilosis
Clinical Examination
• Features of anemia like facial
pallor,pale
conjuctiva,tongue,palmer creases
and nail beds.
• Tongue may have painful ulcers
and necrotic lesions in mouth
• Sternal tenderness near lower or
middle third :acute leukemia
Clinical Examination
• Palpation of liver and spleen and
generalized
lymphedenopathy:chronic infection
and hemolytic anemia.
• Hemic murmurs are common
cardiac signs
• Basal crepitation in lungs suggest
congestive heart failure with severe
anemia.
Laboratory investigation
Hemotological
Investigation
• CBC
– RBC COUNT,Hb
– RBC INDICES
– WBC COUNT
– PLATELET COUNT
– CELL MORPHOLOGY
• Reticulcyte count
• Iron supply studies: Serum
iron,TIBC,s.ferritin
• Marrow examination
Other investigation
• Urine: Hematuria,pus cells,casts
• Urine culture: infection
• LFT
• Stool examination
• Xray chest
• Hemoglobinuria, Hemosiderinuria
• Serum Haptoglobin, S.bilirubin
Iron Deficiency anemia
• Serum ferritin: <12ng/ml:IDA
• Serum iron: <60μg/dl:IDA
• Serum iron binding capacity:
Normal:250-435 μg/dl. Increased
in IDA.
• Serum transferrin receptors, Free
erythropoietin protoporphyrins,
Nestroft test
Interpretation of plasma
Iron
Iron TIBC Ferritin

Iron Decrea Increas Decrea
deficiency se e se
anemia
Anemia of Decrea Decrea Increas
chronic se se e
disease
Pregnancy Increas Increas Normal
e e
B12 and folate deficiency
• Hypersegmented neutrophils
• Orthochromatic macrocytes
• Howell-Jolly bodies
• Nucleated red cells
• Bone marrow examination:
megaloblastic and aplastic
anemia, Serum VitB12 assay,
Serum folate assay
Sickle cell anemia
• Sickling test
• PS : sickle cell,
polychromatophil
ia,basophilic
stippling
• Electrophoresis
• Decrease ESR
Aplastic anemia
• CBC and PS: neutropenia,
lymphocytosis,
thrombocytopenia
• Blood test:electrophoresis
• Serum transaminase, bilirubin,
LDH,Coombs test, RFT
• Bone marrow: Hypocellular
with fatty replacement and
plasma cells and mast cell
Thank you

My references: