Presentation on theme: "Anemia Introduction Dr. Sachin Kale, MD."— Presentation transcript:
1Anemia Introduction Dr. Sachin Kale, MD. Asso. Prof, Dept. of pathologyIn charge, Central Laboratory, MGM.
2Outline Introduction to anemias Introduction to hematology and hematopoiesisIntroduction to anemiasIron deficiency anemiasMegaloblastic anemia.Sickle cell anemia
3AnemiasSignifies a decrease in Hb or Hct and represents underlying disease than a specific diagnosisAccepted definitions -Male: < 13.5 g/dlFemale: < 12.5 g/dlPregnancy & Children - ( 6 m – 8 yrs): < 11 g/dlPreterm infants: < 14 ; Full term infant: < 13.5
4AnemiasSaO2 ( % of heme groups occupied by O2) and PaO2 ( amount of O2 dissolved in plasma) are normal; since O2 exchange in lungs are normal.However oxygen content (total amt of O2 available) is decreased owing to reduction in Hb concentraion.
5Mature RBC Anucleate cells Devoid of mitochrondria – lack citric acid cycle, beta oxidation of fatty acid, oxidative phosphorylationMetabolize glucose by anerobic glycosylation – lactate is the end product.Generate glutathione via pentose phosphate shunt.
6Mature RBCReduce heme iron from ferric (+3) to ferrous (+2) state using methemoglobin reductase system Synthesizes 2,3 bisphosphoglycerate via Rappapor-Luebering shunt. ( used for right shifts in O-D curve)ABO & Rh antigens on membranes.
7Mature RBCSenescent RBCs are removed mainly by extravascular hemolysis – endproduct is lipid soluble unconjugated bilirubin.Lesser extent – intravascular hemolysis.
8Anemia: symptoms Tissue hypoxia Dyspena with exertion Weakness, fatigue, anorexia, insominia, inability to concentrate, and dizziness (CNS hypoxia)
11Basic pathophysiological categories of anaemia Blood lossImpaired red cell productionInadequate supply of nutrients essential for eythropoiesis, such as: .iron deficiencyvitamin B 12 deficiencyfolic acid deficiencyprotein-calorie malnutritionother less common deficiencies
12Impaired red cell production Depression of erythropoietic activityAnaemia associated with chronic disorders. such as:infectionconnective tissue disordersinflammatory disordersdisseminated malignancyAnaemia associated with renal failureAplastic anaemiaAnaemia due to inherited disorders, such as thalassaemia
13Impaired red cell production Anaemia due to replacement of normal bone marrow by:LeukaemiaLymphomamyeloproliferative disordersMyelomamyelodysplastic disorders
14Excessive red cell destruction Due to intrinsic defects in red cellsDue to extrinsic effects on red cells
15General evidence of hemolysis Evidence of increased HB breakdown:Jaundice and HyperbilirubinemiaEvidence of compensatory erythroid hyperplasia:ReticulocytosisEvidence of damage to red cells:SpherocytosisFragmentation RBCsHeinz bodies
16Classification of anemias Microcytic anemias: ( MCV < 80 fl)Iron deficiency (most common)ThalassemiaAnemia of chronic diseaseSideroblastic anemia
42Understanding CBC: the complete blood count Haematocrit is 3 times the HB value: Rule of 3.RBC count usually parallels HB and Hct,In thallasemias RBC count is normal to increased even though Hb is low.RDW: Red cell distribution widthWBC count: Total and differentialBlood film:
43RBC indices MCV: volume of average red cell (fl or um3) MCV = Hctx1000/RBC count ( in millions per ul)MCH: content (wt) of Hb of average red cellMCH = Hb (g/l)/RBC ( in millions per ul)MCHC: average concentration of Hb in given volume of packed cells.MCHC: Hb(g/dl)/Hct
46All of the following cause microcytic anemia except Iron deficiency anemiaThalasemiaGerm cell tumorsSeminomaSpermatocytic seminomaEmbryonal carcinomaYolk sac tumorAlcoholic liver diseaseAnemia of chronic disease
47All of the following cause microcytic anemia except Iron deficiency anemiaThalasemiaGerm cell tumorsSeminomaSpermatocytic seminomaEmbryonal carcinomaYolk sac tumorAlcoholic liver diseaseAnemia of chronic disease
49Hereditary spherocytosis All of the following cause normocytic anemia with reti count < 2%, exceptAplastic anemiaHereditary spherocytosisGerm cell tumorsSeminomaSpermatocytic seminomaEmbryonal carcinomaYolk sac tumorAcute blood lossAnemia of renal disease
50Hereditary spherocytosis All of the following cause normocytic anemia with reti count < 2%, exceptAplastic anemiaHereditary spherocytosisGerm cell tumorsSeminomaSpermatocytic seminomaEmbryonal carcinomaYolk sac tumorAcute blood lossAnemia of renal disease
60Which of the following is present in both IDA & Thalassemia Low Ferritin concentrationMicrocytic RBC IndicesGerm cell tumorsSeminomaSpermatocytic seminomaEmbryonal carcinomaYolk sac tumorAbnormal Hb electrophoresisAll of the above
61Which of the following is present in both IDA & Thalassemia Low Ferritin concentrationMicrocytic RBC IndicesGerm cell tumorsSeminomaSpermatocytic seminomaEmbryonal carcinomaYolk sac tumorAbnormal Hb electrophoresisAll of the above
62A well executed CBC followed by its proper interpretation has its worth in gold and a shrewd clinician make use of this simple and cheap test for diagnosing hematological and even non-hematological disorders..Dr. M. B Agrawal.
63“ Mind is like a Parachute - it works only when it is open “ “Eyes can only see,what mind can think! “54