Anemia physical examination
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Overview
Anemia goes undetected in many people, and symptoms can be vague. The signs and symptoms are similar in different types of anemia. The presentation may vary depending on the acuteness of onset, hematocrit levels, and the general health conditions of the patient (age, sex, pregnancy, cardiac conditions, and any other comorbidities) rather than only the etiology behind the anemia. A hematocrit level of between 30 - 35 usually produces no symptoms whereas, a fall of heamtocrit levels to 15 - 20 may produce severe symptoms (shortness of breath, syncope). However, most patients will experience some symptoms related to anemia when the hemoglobin level reaches 7 g/dL.
Physical examination
Common in all causes anemia
- Pallor (pale skin, mucosal linings and nail beds) is often a useful diagnostic sign in moderate or severe anemia, but it is not always apparent. Commonly seen in nail bed, palm crease, and conjunctiva.
Physical findings associated with specific anemia
Iron deficiency anemia
Iron deficiency anemia secondary to bleeding
Iron deficiency anemia secondary to malabsorption
Vitamin B12 deficiency
- Chelitis
- Glossitis
- Decreased proprioception, and vibratory sensation