1. Anemia Definition Physiological Pathological Classification:
I- ↓ production:
1)↓ precursors
2)Chronic infection, inflammation and Renal disease.
3)↓ specific factors.
II-↑ destruction or blood loss.

2. Clinical features: Symptoms: Signs:
pallor
Fatigue
Irritability
Weakness
Shortness of breath
Decreased appetite
Headache - frontal
Pallor
Others- according to type of anemia
Hemic murmur and heart failure

3. Iron deficiency anemia
Etiology:
Decreased supply
Increased requirement
Decreased absorption
Chronic blood loss
Symptoms:   
Pallor
Brittle nails
Unusual food cravings (pica)
Oral lesions; Sore tongue
behavioral, cognitive and psychomotor deficits
Note: There may be no symptoms if anemia is mild

4. Signs:
Pallor
Splenomegaly
Nail changes
Others.

5. Investigations: Blood: -Hypochromic microcytic anemia.
-Poikiliocytosis.
-platelets.
-Reticulocyte count
-S.I, TIBC, T.S, S.Ferritin
-B.M.
Stool

9. Treatment Iron therapy. Oral iron (ferrous sulfate)
Diet. meats, liver, poultry, fish, leafy greens legumes. Ascorbic acid→↑ absorption & tannates (tea, coffee), Calcium, Phosphate, antacids, phytates ↓ absorption of iron.
D/D: 1) Thalassemia trait.
2) Lead poisoning.
3) sideroblastic anemia.

10. Stages of iron deficiency
1) ↓ in iron stores.
2) ↓ S. Ferritin.
3) ↓ S. iron.
4) progressive anemia.
5) ↓ activity of I.C. enzymes.
Response to therapy
1) ↑ I.C. Iron enzymes.
2) Initial BM response.
3) ↑ Reticulocytes (5-7d)
4) ↑ Hb% (4-30 d).
5) Repletion of iron stores.

11. Megaloblastic anemia A- Folic Acid Deficiency:
1) ↓ intake )↑ requirement ) ↓ absorption.
H.A, Anticonvulsants, Cytotoxic drugs & Sulfonamides.
Clinical manifestations: 4-7 months.
Lab. Data:
1- ↑MCV ↓S. folate ↓Ret. Count.
4-Megaloblastic morphology. 5-Pancytopenia.
Treatment: Oral folic acid.

12. B12 Deficiency ↓ intake. ↓ intrinsic factor.
Interference with I. factor B12 complex.
Disease of terminal ileum.
Juvenile P.A.
Clinical manifestations: 1) general. 2)glossitis.
3) neurological manifestations.
Lab. Data: -Blood indices Schilling test.

16. - secondary: drugs, toxins, infections, Radiation.
Aplastic Anemia
Genetic ( Fanconi anemia)
Acquired - idiopathic
- secondary: drugs, toxins, infections, Radiation.
Fanconi anemia :
- inheritence (AR)
-age (7-8)
- risk for cancer.

17. Congenital abnormalities:
Short stature
Thumb and arm anomalies - misshapen or missing thumbs, an incompletely developed or missing radius
Other skeletal anomalies - hips, spine, and ribs
Kidney malformations.
Skin discoloration (cafe-au-lait spots)
Microcephaly and micro-ophthalmia.
Mental retardation or learning disabilities
Low birth weight.
Gastro-intestinal malformations.
Small testicles.
Heart defects.

18. Diagnosis: - Pancytopenia.
-Chromosomal breakage.
- Hypocellular BM.
Treatment: 1) Supportive therapy.
2) Marrow stimulants.
3) Immunosuppressive therapy; ATG, corticosteroids.
4) BMT.

19. Thanks & Good luck