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Paolo Aquino PGY-I January 2005 VA HospitalAnemia Paolo Aquino PGY-I January 2005 VA Hospital
Definition Anemia is a reduction of hemoglobin or volume of red blood cells from normal limits Variation due to age, gender Decreased production Increased loss
History Signs of blood loss Onset- rapid vs. gradual Family historyExposures Diet History of infection PMH- cancer, renal, endocrine
Physical exam Appearance Vital signs HEENT Heart Abdominal
Laboratory studies Hemoglobin and hematocrit Mean corpuscular volumeReticulocytes Peripheral smear
Microcytic anemia Most common cause: iron-deficiency anemiaThalassemia Lead poisoning Sideroblastic anemia Anemia of chronic disease
Normocytic anemia Marrow hypoplasia Marrow infiltration MyelofibrosisRenal insufficiency Anemia of chronic disease Mild iron deficiency Mixed microcytic/macrocytic
Approach History and physical Hemoglobin, hematocritReticulocytes decreased production, increased loss Remember to correct the retic count for the anemia
Approach If reticulocytes low, check MCVLow MCV: check iron studies, examine peripheral blood smear, hemoglobin electrophoresis Normal MCV: check iron studies, examine peripheral blood smear, test endocrine function, consider bone marrow aspiration
Peripheral smear Normal RBC size equal to nucleus of a mature lymphocyte Shape Spherocytes Sickle cell Helmet cells Tear drop cells
Peripheral smear Color Hypochromasia Hyperchromasia Iron deficiencySideroblastic Hyperchromasia Megaloblastic anemia Spherocytosis
Peripheral smear Morphology Howell-Jolly bodies Basophilic stipplingHeinz bodies Requires supravital stain Cabot ring Nuclear remnants
Peripheral smear Morphology Rouleaux formation ParasitesNucleated RBCs Target cells
Summary Once anemia is established Check reticulocyte countCorrect count for anemia Increased retic count indicates RBC loss- hemolysis or bleed Decreased retic count indicates decreased RBC production Check MCV
Summary Decreased reticulocyte count Normocytic Microcyticcheck iron studies, examine peripheral blood smear, test endocrine function, consider bone marrow aspiration Microcytic check iron studies, examine peripheral blood smear, hemoglobin electrophoresis
RED BLOOD CELL MORPHOLOGY
HEMATOLOGY WHAT IT IS : Study & measurement of individual elements of Blood. WHAT IT’S COMPOSED OF. SHOW SLIDES FROM PERIPHERAL BLOOD TUTOR CD OR USE PLATE.
Classification of anemia
Approach to Anemia - Summary
ANEMIA SLIDES. RETICULOCYTE, SUPRAVITAL STAIN NUCLEATED RBCs: METARUBRICYTE (A Blast is almost all nucleus)
Clinical pathology department SCU
LABORATORY DIAGNOSIS RED BLOOD CELLS.
Anemia Dr. Meg-angela Christi M. Amores. What is Hematopoeisis? It is the process by which the formed elements of the blood are produced Erythropoeisis:
This lecture was conducted during the Nephrology Unit Grand Ground by a Sub-intern under Nephrology Division, Department of Medicine in King Saud University.
An Approach to Anemia.
MLAB Hematology Keri Brophy-Martinez
Morphology of RCB in health and disease Hematology CLS 531 Prepared by: Hajar AlQadeeb.
Interpreting The CBC Francisco F. Lopez, MD The 2005 Advanced Medical Underwriting Course January 14, 2005.
Anemia: Diagnosis and Clinical Considerations
RBCs Abnormal morphology
Classification of anemias
Physiology Presentation Roll No.# 218, 224, 230, 236, 242, 248 Muhammad Mohsin Ali Dynamo.
Laboratory Procedures. Polychromasia:______________________________ ____________________________________________ Anisocytosis:________________________________.
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