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Questions and Answers
Which type of anemia involves absent or decreased iron stores?
Which type of anemia involves absent or decreased iron stores?
- Hyperthyroidism
- Iron deficiency anemia
- Iron depletion (correct)
- Thalassemia
Where is the majority of the body iron located?
Where is the majority of the body iron located?
- Heme molecules of hemoglobin (correct)
- Bone marrow
- Liver
- Muscle myoglobin
What laboratory test measures the capacity of transferrin to bind iron?
What laboratory test measures the capacity of transferrin to bind iron?
- Hemoglobin electrophoresis
- Serum iron test
- Total iron binding capacity (correct)
- Ferritin test
Which of the following is NOT a cause of microcytic hypochromic anemia?
Which of the following is NOT a cause of microcytic hypochromic anemia?
What is the transport form of iron in the body?
What is the transport form of iron in the body?
Which type of hemoglobinopathy involves the combination HbSC?
Which type of hemoglobinopathy involves the combination HbSC?
Which of the following is a cause of megaloblastic anemia?
Which of the following is a cause of megaloblastic anemia?
Which of the following is NOT categorized as a non-megaloblastic macrocytic anemia?
Which of the following is NOT categorized as a non-megaloblastic macrocytic anemia?
What is assessed to determine if a patient is anemic?
What is assessed to determine if a patient is anemic?
Which of the following investigations helps determine the type of anemia?
Which of the following investigations helps determine the type of anemia?
Which of the following conditions is NOT associated with endocrine diseases that could lead to anemia?
Which of the following conditions is NOT associated with endocrine diseases that could lead to anemia?
What defines anemia according to WHO criteria?
What defines anemia according to WHO criteria?
Which of the following is not typically a symptom or sign of anemia?
Which of the following is not typically a symptom or sign of anemia?
How can dehydration affect the diagnosis of anemia?
How can dehydration affect the diagnosis of anemia?
What is a common cause of poor oxygenation of tissues in anemia?
What is a common cause of poor oxygenation of tissues in anemia?
Which of these is a compensatory response to anemia?
Which of these is a compensatory response to anemia?
Anemia is rarely a disease by itself but rather a consequence of:
Anemia is rarely a disease by itself but rather a consequence of:
Which clinical feature is not a direct symptom of tissue hypoxia in anemia?
Which clinical feature is not a direct symptom of tissue hypoxia in anemia?
Which condition may lead to hemodilution and a false diagnosis of anemia?
Which condition may lead to hemodilution and a false diagnosis of anemia?
Which of the following is NOT a symptom of anemia?
Which of the following is NOT a symptom of anemia?
Which classification of anemia is categorized by a Mean Corpuscular Volume (MCV) of less than 80 FL?
Which classification of anemia is categorized by a Mean Corpuscular Volume (MCV) of less than 80 FL?
Which factor does NOT determine the presence or absence of clinical symptoms in anemia?
Which factor does NOT determine the presence or absence of clinical symptoms in anemia?
Which of the following conditions is a type of microcytic anemia?
Which of the following conditions is a type of microcytic anemia?
Which investigation is used to determine the cause of anemia?
Which investigation is used to determine the cause of anemia?
What classification of anemia is defined by an MCV of 80-100 FL?
What classification of anemia is defined by an MCV of 80-100 FL?
Which of the following anemias is caused by increased destruction of red blood cells?
Which of the following anemias is caused by increased destruction of red blood cells?
Which of the following is typically NOT a symptom of anemia?
Which of the following is typically NOT a symptom of anemia?
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Study Notes
Definition of Anemia
- Anemia is a reduction in hemoglobin (Hb) concentration below reference values for age and sex.
- Reference values vary with race, altitude.
- WHO defines anemia as Hb level below 12 g/dL in women and 13 g/dL in men.
Characteristics of Anemia
- Low red blood cells
- Poor oxygenation of tissues
- Normal amount of white blood cells
Changes in Plasma Volume
- Reduction in plasma volume (e.g., in dehydration) may lead to hemoconcentration with apparent increase in Hb level, underestimating or masking anemia.
- Increase in plasma volume (e.g., in pregnancy) may lead to hemodilution with apparent decrease in Hb level, causing wrong diagnosis of anemia.
Clinical Features of Anemia
- Symptoms and signs are mainly due to tissue hypoxia and compensatory attempts.
- Fatigue, weakness, tiredness, and reduced exercise tolerance.
- Generalized muscular weakness, palpitation, and dyspnea during activity.
- Pallor of mucous membranes, headache, faintness, and giddiness.
Anemia Symptoms
- Fatigue, headache, yellowish skin, irregular heartbeats, chest pain, cold hands, dizziness, leg cramps, insomnia, and shortness of breath.
Factors Affecting Clinical Symptoms
- Speed of onset of anemia: anemia of slow onset produces fewer symptoms.
- Severity of anemia: mild anemia usually produces no symptoms or signs.
- Age of the patient: the young tolerates anemia better than the elderly.
Classification of Anemia
- Morphologic: microcytic, normocytic, and macrocytic anemia based on MCV.
- Pathogenic: blood loss, decreased RBC production, and increased RBC destruction.
Types of Anemia
- Microcytic anemia: iron deficiency anemia, thalassemia, lead poisoning, and anemia of chronic diseases.
- Normocytic anemia: acute post-hemorrhagic anemia, hemolytic anemia, aplastic anemia, and chronic diseases.
- Macrocytic anemia: megaloblastic and non-megaloblastic anemia.
Diagnosis and Investigations
- Is the patient symptomatic?
- What is the severity of anemia?
- What is the Hb level?
- RBC count, Hct, and reticulocyte count.
- Red cell indices, morphology, and cause of anemia.
Megaloblastic Anemia
- Caused by vitamin B12 deficiency and folic acid deficiency.
Non-Megaloblastic Anemia
- Caused by liver disease, alcoholism, hypothyroidism, aplastic anemia, and anemia of acute bleeding.
Microcytic Hypochromic Anemia
- Caused by hemoglobinopathies, inflammation, and others (rare).
Iron Deficiency Anemia
- One of the most common medical problems.
- Most common cause of anemia.
- 3 stages of iron depletion and iron deficiency: iron depletion, iron deficiency, and iron deficiency anemia.
Body Iron
- Total amount of body iron: 3-5 gm.
- Iron is present in hemoglobin, myoglobin, and iron-containing enzymes.
- Storage forms are ferritin and hemosiderin.
- Transport iron is bound to transferrin.
Total Iron Binding Capacity
- A laboratory test that measures the capacity of transferrin to bind iron.
- Transferrin saturation = serum iron/TIBC%.
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