Anemia resident survival guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Chetan Lokhande, M.B.B.S [2]

Definition

Anemia is defined as a decrease in oxygen-carrying capacity of the blood . It is measured in unit volume concentrations of hemoglobin (Hb), red blood cell volume (MCV), red blood cell number (RBC count).

Causes

Life Threatening Causes

1. Aplastic crisis
2. Sickle cell crisis
3. Severe Hemorrhage

Most Common Causes

Inadequate production

1. Iron deficiency anemia
2. Thalassemia
3. Megaloblastic anemia ( Vit B12 , Folate )
4. Hypothyroid
5. Chronic renal disease
6. Bone marrow suppression
7. Pregnancy

Hemolysis

1. Autoimmune hemolytic anemia
2. Hemoglobinopathies
3. RBC membrane defect
4. Splenic sequestration
5. Sickle cell anemia

Management

↓ EPO production or improper response to EPO |F02=Maturation defect|F03=Maturation defect|F04=Fragmented cells on peripheral smear F05=No fragmented cells on peripheral smear

INDICATIONS FOR TESTING Fatigue, weakness, pallor, dizziness, fainting

Check routine Labs, CBC , smear and reticulocyte count and index

Diagnosed as anemia if Hgb in males < 13g / dl and in females if Hgb < 12g / dl Check whether reticulocyte index ≥ 2.5

If No Check RBC indices

If Yes then

Normal MCV / MCHC Normocytic Normochromic

Low MCV / MCHC Microcytic Hypochromic

High MCV Macrocytic

Check peripheral smear

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*Bone marrow disorder *Inflammation *Autoimmune disease *Chronic renal disease *Critical illness *Chronic endocrinedisorders *Aplastic anemia *purered cell aplasia

*Iron deficiency *Chronic disease *Thalassemia (Hemoglobinopathies) *Sideroblastic anemia *Lead toxicity

*Folate, B12 deficiency (Megaloblastic Anemia) * Drug effect *Excessive alcohol use *Hypothyroidism *Myelodysplasia (Myelodysplastic Syndromes)

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References

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