ANEMIA

INTRODUCTION
INTRODUCTION::

 Anemia is a major killer in india .

 statics reveal that every second indian woman is anemic .
 one in every five maternal deaths is directly due to anemia .
 Anemia affects both adults and children of both sexes ,
although pregnant women and adolescent girl are most
susceptible and most affected by this disease .
 World
. Health Organization ( WHO ) proposed the cut – off
points of Hb level for different age groups fot the diagnosis of
anemia .
1 ) children 6 month to 6 years ; 11 g / dl
2 ) Children 6 year to 14 years ; 12 g / dl
3 ) Above 14 years ; Male : 13 g / dl
Female : 12 g /dl
 DEFINITION :
 Anemia ( An – without , Emia – blood )
is a decrease in the RBC count ,
hemoglobin and / or Hematocrit values
resulting in a lower ability for the blood to
carry oxygen to body tissues .
 RISK FACTORS OF ANEMIA

A diet lacking in certain vitamin

• intestinal disorders
• menstruation
• Pregnancy
• Chronic condition
• Family history
• other factors
• Age
.
 CAUSES OF ANEMIA
 Excessive bleeding
 Leaky gut
 Low stomch Acid
 Iron Deficiency
 B12 deficiency
 Folate Deficiency
 Poor diet
• Chronic disease
.
• Intestinal Disease
• infection
• Kidney disease
• Liver disease
• Thyroid disease
• Pregnancy
• Auto immunity
.
 CLASSIFICATION

Classification of Anemia

On the basis of On the basis of

cause morphology

Blood Inadequate Excessive Normo Microc Macro

destruction
loss production of
normal blood of blood
cytic ytic cytic
cells cells
 ON THE BASIS OF CAUSE
1. Blood loss : a . ACUTE
b . Chronic
2 . Inadequate production of normal blood cells :
a ) Iron deficiency
b ) Megaloblastic
c ) Aplastic anemia
d ) Anemia or chronic disease
3 ) Exessive
. distruction of blood cell :
A ) Extrinsic to red blood cell
- Auto immune or iso immune infection
- Physical or chemical agents
B ) Intrinsic to red blood cell
- membrane defect
- Enzyme deficiencies
 ON THE BASIS OF MORPHOLOGY
1 ) Macrocytic : If red blood cell are larger than normal it is called macrocytic .
a ) Megaloblastic anemia
b ) Vitamin B 12 , Folate deficiency
2 ) Normocytic : If the red blood cells are normal in size ( but less in amount ) this is
called normocytic anemia .
a ) Acue blood loss
b ) Anemia of chronic disease
c ) Aplatic anemia
d ) Hemolytic anemia
3 .) Microcytic : if red blood cells are smaller in size than
normal this is called microcytic anemia .
a ) iron deficiency anemia
b ) Anemia of chronic disease
c ) Thalasemia
 TYPES OF ANEMIA
1) Iron deficiency anemia
2) vitamin deficiency anemia
3) Anemia of imflamation
4) Aplastic anemia
5) Anemia associated with bone marrow disease
6) leukemia
7 ) .Hemophilia
8 ) Hemolytic
a ) Sickle cell anemia
b ) Thalasemia
.
 SIGN AND SYMPTOMS
 Respiratory : Shortness of breathing
 Digestive system : Change in stool coloure
 Muscles : pain
 Heart : Angina and heart attack
 Spleen : Enlargement
 Skin : Yellowing
 COMPLICATION OF ANEMIA
 Hypoxia
 Sever Ftigue
 Physical and mental growth retardation
 Neurological damage
 Heart problem : irregular heart rate , heart enlargement ,
heart failure
 Pregnancy complication : pre mature birth
 Death
INVESTIGATION :
INVESTIGATIO
INVESTIGATIO
N
N
 INVESTIGATION OF ANEMIA
 FBC with red cell indices
 serum bilirubin
 vitamin B12
 Red cell folate levels
 Iron studies
 Peripheral blood smear
 Bone marrow sampling
TREATMENT :
 MEDICAL MANAGEMENT
 Trnsfusion therapy
 Oxygene therapy
 Analgesic : morphine , meperidine
 Nutritional supplements
 Monitoring vital signs
 Genetic councelling
 MNAGEMENT
o Collaborative care :
- Treatment of underlying disease / problem
- Replacing iron
- Diet
- Drug therapy
 Iron replacement
 Oral iron
- Fesol , Dexferrum , etc
 .
• perenteral iron
- IM or IV
- Less desirable than PO
 PREVENTION OF ANEMIA
 Diet for iron deficiency : iron reach diet such as ,
 Beat root
 dates
 Jaggery
 Raisins
 Kidney beans
 Red meat
 IRON REACH FOODS
 Pumpkin sids
 Collard greens
 Bok choy
Tomatoes
 Green beans
 Brusseis sprouts
 Broccoli
 Green peas
IRON DEFICIENCY ANEMIA
 DEFINITION :
 Iron deficiency anemia is anemia caused
by a lack of iron , Anemia is defined as a
decrease in the number of red blood cells
or the amount of heamoglobin
 CAUSES OF IRON DEFICIENCY
 Deficiet diet
 Decreased absorption
- Zinc deficiency
 Increse requirements
- Pregnancy
- Lectation
 Blood loss ( Chronic )
- Gastrointestine
- Menstual
- Blood donation
 Hemoglobinuria
.
 Iron sequestration
- Pulmonary hemosiderosis
 Idiopthic
 TREATMENT
TREATMENTOF OFIRON
IRON
DEFICIENCY ANEMIA
DEFICIENCY ANEMIA
 Iron deficiency anemia is treated with oral or parentral iron prepration .
 Oral iron corrects the anemia just as rapidly and completely as parrentral
iron in most cases if iron absorption from the GIT is normal .
 Different iron salt provide different amount of elemental iron .
 in iron deficient individual , about 50 – 80 mg of iron can be incorporated in
hemoglobin daily and about 25 % of oral ferrous salt can be absorbed .
VITAMIN DEFICIENCY ANEMIA
 DEFINITION :
 Vitamin deficiency anemia is a lack of healthy
red blood cells caused when you have lower than
normal amounts of certain vitamins . Vitamins
linked to vitamin deficiency anemia include filate ,
Vit 12 , Vit C .
 CAUSES OF VITAMIN DEFICIENCY
CAUSES OF VITAMIN DEFICIENCY
ANEMIA
ANEMIA
 Alcoholism
 sideroblastic anemia
 Low dietry intake vegans
 pernicious anemia
 bacterial overgrowth
 Fish tapeworm
 Abnormal metabolism
 SIGN
SIGNAND
ANDSYMPTOMS
SYMPTOMS
• Fatigue
• Shortness of breath
• Pale or yellowish skin
• Irregular hertbeats
• weight loss
• Mucles weakness
• Personality changes
• Mental confusion
 TREATMENTOF
TREATMENT OFVITAMIN
VITAMIN
DEFICIENCYANEMIA
DEFICIENCY ANEMIA
o treatment involve eating a healthy diet and taking folic
acid supplements as prescribed by ypor doctor .
o In most cases , folic acid supplements are taken orally .
o Once your body’s level of folate increase to stop taking
the supplements . But if the cause of your folate deficiency
can’t be correct , you may need to take folic acid
supplements indefinitely .
ANEMIAOF
ANEMIA OFIMFLAMATION
IMFLAMATION::
 DEFINITION
DEFINITION
 Anemia of inflammation is typically mild or
moderate , meaning that hemoglobin levels in your
blood are lower than normal but not severely low . If
ypur anemia become severe , the lack of oxygen in
your blood can cause symptoms , such as feeling
tired or short of breath .
 CAUSES
CAUSESOF
OFANEMIA
ANEMIAOF
OFIMFLAMATION
IMFLAMATION
 Autoimmune diseases , such as rheumatoid arthritis
 Cancer
 Chronic infection , such as HIV / AIDS , Tuberculosis
 Inflammatory bowel disease , such as ulcerative colitis
 Chronic kidney disease
 SIGN
SIGNAND
ANDSYMPTOMS
SYMPTOMS
 A fast heartbeat
 body aches
 Feeling tired or weak
 pale skin
 Shortness of breath
 Getting tired easily during or after physical activity
 TREATMENT
TREATMENT
 Blood transfusion
 Intravenous iron supplement
 Medication that are a synthetic form of erythropoietin
stimulate the bone marrow to produce more red blood
cells . They may be recommended if treatment of the
underlying condition is not effective or possible .
.
 DEFINITION::
DEFINITION
 Aplastic anemia is a rare but serious
blood disorder that occure when your
bone marrow can not make enough new
blood cells for your body to work
normaly .
 CAUSES OF APLASTIC ANEMIA

 Radiation
 Chemotherapy
 Antipileptic drug
 Hep – B Virus
 HIV virus
 Thyoma disease
 .
 Pregnancy
 Leukemia
 Myelofibrosis
 Myelodysplasia
 SIGNAND
SIGN ANDSYMOPTOMS
SYMOPTOMSOF
OFAPLASTIC
APLASTICANEMIA
ANEMIA
• General sign and symptoms :
- Pallor or lack of coloure especially mucous membranes
- Fatigue
- Dizziness
- Headaches
- Decrese exercise tolerance
- Shortness of breath
 .

• Decresed RBC’s , WBC’s and platelets

• Nausea
• Skin rashes
 MANAGEMENT
MANAGEMENTOF
OFAPLASTIC
APLASTICANEMIA
ANEMIA
 Hematopoietic stem cell transplantation
 Immunosuppresive treatment
- Cyclosporine
- methylprednisolone
- growth factors
 Androgens
 Supportive therapy
LEUKEMIA
 DFINITION :
 The word leukemia means white blood .
 It defined as an acute or chronic disease in
hunans and other warm – blooded animals
characterized by an ab-normal increase in the no .
Of white blood cells in the tissue and often in the
blood .
CAUSES AND RISK FACTORS
 TREATMENT OF LEUKEMIA
TREATMENT OF LEUKEMIA

 Chemothetapy
 Biological therapy
 Radiation therapy
 Stem cell transplantation
 DEFINITION
DEFINITION ::
 It is disease that causes a person to
blood a lot even from very small
injuries because the blood does not
clot .
 INVESTIGATION

 Prothrombin time
 Bleeding time
 Fibrinogen levels
 TREATMENT
 Hemophhilia treatment varies depending on the severityof
the condition :
 Mild hemophilia A : Tretment may involve slow injection
of the hormone desmopression into vein to stimulate a
release of more cloting factor to stop bleeding .
( desmopressin is given as a nasal medication )
 Moderete to severe hemophilia A or hemophilia B . Bleeding
.
may stop after an infusion of clotting factor derived from donated
human blood or from genetically engineered products called
recombinant clotting factors . Repeated infusion may be needed
if internal bleeding is serious .
 Hemophilia C : The clotting factor missing in this type of
hemophilia ( factor 11 ) is available only in Europe . In the U . S .
, plasma infusions are needed to stop bleeding episodes .
.
 DEFINITION :
 Heamolytic relating to or involving the rupture or
destruction of red blood cells .
 Heamolytic is a disorder in which red blood cells are
destroyed faster than they can be made . The destruction
of red blood cells is called hemoylysis . Red blood celss
carry oxygene . if you have a lower than normal amount
of red blood cells , you have anemia .
 CAUSES OF HEMOLYTIC
oANEMIA
Specific infection , such as viral or bacterial
o Medications , like penicillin , anti – malerial medicienes
o Blood cancer
o Autoimmune disease , like lupus , rheumatoid arthritis ,
ulcerative colitis
o Certain tumors
o A major reaction to a blood transfution
SICKLE CELL ANEMIA
 DEFINITION :
 A sever hereditary form of anemia in which
a mutated from of hemoglobin distorts the red
blood cell into a rescet that at low oxygene
levels .
 CAUSES
CAUSESOF
OFSICKLE
SICKLECELL
CELLANEMIA
ANEMIA
 The sickle cell gene makes abnormal hemoglobin .
 An inherited condition that is autosomal recessive
 SIGN
SIGNANSDANSDSYMPTOMS
SYMPTOMSOF OFSICKLE
SICKLE
CELL
CELL ANEMIA
 SevereANEMIA
pain because of ischemia of tissues and infraction
 pallor
 wakness
 Tachycardia
 Dyspnea
 Jaundice
 Splenomegaly
 Delay of growth and development
.
 Congestive hert failure
 Vascular occlussions and infractions
- in lungs
- small blood vessels
- Hand foot syndrome
 DEFINITION :
 A blood disorder involving lower than normal amount
of an oxygene carrying protein .
 Thalasemic is an inherited blood disorder charecteried
by less O2 carring . Protein ( hb ) and fewer red blood
cells in the body than normal .
 It widw spread in Mediterranean African , and Asian
countries .
SUMMARY