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 Anemias
Definition: ↓↓ Hb concentration below
the normal level for age and sex
Classification: How to diagnose a case
of anemia

History Clinical picture Laboratory

Investigations

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 History

Diet
Drug intake
Acute / chronic Hemorrhage
Jaundice and dark urine
Family history

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 Clinical picture

Pallor
Easy Fatigability
Anorexia
Tachycardia
Hemic murmur
 Laboratory Investigations

Is it a case of What’s the type What’s the

anemia or of this anemia? cause of this
not? Anemia?
Is it a Case of Anemia or Not?

Hb concentration
RBCs count
Hematocrit value

If 3 parameters ↓↓ → anemia
What is the Type of Anemia?
Microcytic hypochromic anemia
Normocytic normochromic anemia
Macrocytic anemia
How to differentiate →by blood indices
– Mean corpuscular volume (MCV)
– Mean corpuscular Hb (MCH)
– Mean corpuscular Hb conc (MCHC )
?What is the Cause of Anemia

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What is the Cause of Anemia?
1- Microcytic Hypochromic Anemia

AE:
– Iron deficiency
– Thalassemia
– Chronic Infection
– Lead poisoning
Diagnosis:
– serum Iron Ferritin
– Hb electrophoresis
– History of Infection
– serum lead estimation
What is the Cause of Anemia?
2- Macrocytic Anemia

AE:
– Anemia of newborn → excluded by age
– Megaloblastic anemia
Folic acid def. anemia (FiGlu test)
Vit B 12 def. → (Schilling test)
What is the Cause of Anemia?
3- Normocytic Normochromic Anemia

AE:
– Aplastic Anemia
– Leukemia
– Hemorrhagic Anemia
– Hemolytic Anemia
Diagnosis

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 Reticulocytic Count

High Low

Hemorrhagic Hemolytic Aplastic Leukemia

Coombs test

+ve -ve
Immune Non immune

Auto immune ISO immune Congenital Acquired

 Hemolytic Anemia
Definition:
Excess destruction of RBCs before its normal life
span.
Types:
ISO immune:
– Rh incompatibility
– ABO incompatibility
Auto Immune:
– Primary
– Secondary:
Infection Collagen diseases
Drugs malignancy
Liver diseases Paroxysmal Hemoglobinuria
Non Immune:
– Acquired:
Drugs bacteria
Parasite Burns
– Congenital:

Defect in Defect in cell membrane Defect in Hb

enzyme cong. sickle cell anemia
G6PD microspherocytosis (Hb electrophoresis)
(enz. assay)
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