Anemia Basics Quiz
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Questions and Answers

What are the two things that can be reduced to cause anemia?

Hemoglobin concentration or RBC count.

What is the lower extreme of the normal hemoglobin taken as for males?

13.0 g/dl.

What are the three main categories of anemia based on etiology?

  • Increased blood loss, impaired red cell production, decreased red cell destruction
  • Increased blood loss, impaired red cell production, normal red cell destruction
  • Decreased blood loss, impaired red cell production, increased red cell destruction
  • Increased blood loss, impaired red cell production, increased red cell destruction (correct)

    • What are the two categories of cytoplasmic maturation defects in red cell production?

    <p>Deficient heme synthesis and deficient globin synthesis</p> Signup and view all the answers

    What are the two categories of nuclear maturation defects in red cell production?

    <p>Vitamin B12 and/or folic acid deficiency and thalasseemic syndromes</p> Signup and view all the answers

    What are the two categories of increased red cell destruction?

    <p>Extrinsic red cell abnormalities and intrinsic red cell abnormalities</p> Signup and view all the answers

    Match the following morphological classifications of anemia with their corresponding RBC characteristics.

    <p>Microcytic Hypochromic = * MCV: reduced</p> <ul> <li>MCHC: reduced Normocytic Normochromic = * MCV: Normal</li> <li>MCHC: Normal Macrocytic Normochromic = * MCV: Raised</li> <li>MCHC: Normal Microcyte = Smaller than normal red blood cell Macrocyte = Larger than normal red blood cell Hypochromic = Pale color due to low hemoglobin concentration Normochromic = Normal color with adequate hemoglobin concentration</li> </ul> Signup and view all the answers

    What are the three main things investigated in peripheral blood smear examination?

    <p>Variation in size (Anisocytosis), variation in shape (Poikilocytosis), and inadequate hemoglobin formation (Hypochromasia).</p> Signup and view all the answers

    The MCV (Mean Corpuscular Volume) is the mean volume of the RBC, expressed in femtoliters.

    <p>True</p> Signup and view all the answers

    The MCH (Mean Corpuscular Hemoglobin) indicates the amount of hemoglobin per RBC and is expressed in picograms.

    <p>True</p> Signup and view all the answers

    The MCHC (Mean Corpuscular Hemoglobin Concentration) is a measure of the concentration of hemoglobin in a red blood cell.

    <p>True</p> Signup and view all the answers

    The RDW (Red Blood Cell Distribution Width) is a quantitative measure of anisocytosis.

    <p>True</p> Signup and view all the answers

    What are the clinical presentation signs of anemia?

    <p>Pallor, cardiovascular system abnormalities, central nervous system abnormalities, reproductive system abnormalities, gastrointestinal system abnormalities, ocular manifestations, and lymphatic system abnormalities.</p> Signup and view all the answers

    What are the two most common and characteristic signs seen in mucous membranes, conjunctiva, and skin?

    <p>Pallor and jaundice.</p> Signup and view all the answers

    What are the clinical presentation symptoms of anemia?

    <p>Tiredness, easy fatiguability, generalized muscular weakness, lethargy, headache, cardiac failure, angina pectoris, intermittent claudication, confusion, and visual disturbance.</p> Signup and view all the answers

    What does the term 'anisocytosis' refer to?

    <p>Variation in red blood cell size</p> Signup and view all the answers

    What does the term 'hypochromasia' refer to?

    <p>Inadequate hemoglobin formation</p> Signup and view all the answers

    What does the term 'compensatory erythropoiesis' refer to?

    <p>Increased red blood cell production in response to anemia</p> Signup and view all the answers

    What two things can lead to megaloblastic anemia?

    <p>Vitamin B12 and/or folic acid deficiency.</p> Signup and view all the answers

    What are the symptoms of aplastic anemia?

    <p>Peripheral pancytopenia and marrow hypoplasia.</p> Signup and view all the answers

    What is pancytopenia?

    <p>Pancytopenia is a clinical condition where there is a significant reduction in the number of almost all blood cells (red blood cells, white blood cells, and platelets).</p> Signup and view all the answers

    What is the clinical presentation in anemia?

    <p>It varies based on the cause, severity, and individual patient response. Common signs include pallor, fatigue, shortness of breath, and palpitations.</p> Signup and view all the answers

    How does anemia affect the body?

    <p>It causes tissue hypoxia, leading to various symptoms such as fatigue, weakness, shortness of breath, dizziness, palpitations, and pallor.</p> Signup and view all the answers

    Study Notes

    Anemia Basics

    • Anemia is a clinical condition where the blood's capacity to transport oxygen to tissues is reduced due to a lower than normal hemoglobin concentration or a reduced RBC count.
    • In adults, normal hemoglobin levels are 13.0 g/dL for males and 11.5 g/dL for females.
    • Anemia can present with various symptoms, including dizziness, headaches, chest pain, paleness, fatigue, and cold skin.

    Lecture Objectives

    • Diagnose anemia by applying diagnostic steps.
    • Explain compensatory mechanisms and clinical presentation of anemia.
    • Identify different types of anemia based on underlying mechanisms and RBC indices.
    • Identify causes of aplastic anemia and pancytopenia.

    Etiological Classification of Anemia

    • Anemia due to blood loss:
      • Acute post-hemorrhagic anemia
      • Chronic blood loss
    • Anemia due to impaired red blood cell production:
      • Defects in heme synthesis (iron deficiency anemia)
      • Defects in globin synthesis (thalassemic syndromes)
      • Defects in nuclear maturation (vitamin B12/folate deficiency, megaloblastic anemia)
      • Defects in stem cell proliferation/differentiation (aplastic anemia, pure red cell aplasia)
    • Anemia due to increased red blood cell destruction (hemolytic anemia)
      • Extrinsic (extracorpuscular) abnormalities
      • Intrinsic (intracorpuscular) abnormalities (details in Table 10.10)

    Morphological Classification of Anemia

    • Microcytic hypochromic:
      • Reduced mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC).
      • Includes: thalassemia, anemia of chronic disease, iron deficiency anemia, lead poisoning, sideroblastic anemia
    • Normocytic normochromic:
      • Normal MCV and MCHC.
    • Macrocytic normochromic:
      • Raised MCV, normal MCHC.
      • Includes: vitamin B12 deficiency, folate deficiency, thiamine deficiency
    • Other types:
      • High reticulocyte count: sickle cell anemia, hereditary spherocytosis, autoimmune hemolytic anemia, paroxysmal nocturnal hemoglobinuria, enzyme deficiency
      • Low reticulocyte count: renal failure, anemia of chronic disease, myelofibrosis, cancers (metastasis or leukemias)

    Diagnostic Approach in Anemia

    • History (menstrual bleeding, chronic blood loss, trauma, injury)
    • Clinical examination (signs & symptoms)
    • Lab investigation:
      • Hemoglobin estimation and complete blood count (CBC)
      • Peripheral blood film examination (variation in size/shape, inadequate hemoglobin formation)
      • Red blood cell indices
      • Leucocyte and platelet count
      • Reticulocyte count
      • Bone marrow examination
    • Biochemical tests (serum iron, folate, vitamin B12 levels)

    Diagnostic Workout of Anemia

    • An algorithm outlining a diagnostic process for various types of anemia.
    • Includes considerations for microcytic, normocytic, and macrocytic anemia, along with normal or low/high ferritin.
    • Leading to specific diagnoses such as thalassemia, iron deficiency anemia, hemolytic anemia, etc.

    Pancytopenia

    • Pancytopenia is a condition characterized by a significant reduction in red blood cells, white blood cells, and platelets.

    Causes of Pancytopenia

    • Aplastic anemia
    • Myelodysplastic syndromes
    • Hypersplenism
    • Megaloblastic anemia
    • Paroxysmal nocturnal hemoglobinuria
    • Bone marrow infiltrations (hematological or non-hematological malignancies, storage diseases, myelofibrosis)

    Bone Marrow Examination

    • Provides insights into the cellularity and ratio of different cell types (M:E ratio)
    • Examines erythropoiesis, myelopoiesis, megakaryopoiesis, and bone marrow iron stores.

    Biochemical Tests

    • A table that can be used to define normal ranges of serum ferritin, serum iron, serum transferrin saturation, total plasma iron-binding capacity (TIBC), serum transferrin receptor (TFR), and red cell protoporphyrin in anemia.

    Compensatory Mechanisms in Anemia

    • The body's response to anemia involves various pathways and hormonal mechanisms to maintain adequate oxygen delivery to tissues.
    • Mechanisms to increase oxygen-carrying capacity include increased heart rate, stroke volume, cardiac dilation, peripheral vasodilation, and increase in erythrocytes

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    Description

    Test your knowledge on the basics of anemia with this quiz. Learn about its clinical presentation, diagnostic steps, and different types of anemia. Understand the underlying mechanisms and causes of conditions like aplastic anemia and pancytopenia.

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