Anemia Lecture Notes

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Questions and Answers

What is the primary definition of anemia?

Excessive blood loss

Increased red blood cell destruction

Insufficient red blood cell production only

Decreased healthy red blood cells to carry oxygen (correct)

Which of the following is the most common cause of anemia worldwide?

Genetic disorders

Chronic inflammatory diseases

Iron deficiency (correct)

Vitamin B12 deficiency

Which condition is characterized by decreased total iron body content?

Chronic kidney disease

Sideroblastic anemia

Iron deficiency (correct)

Hypopituitarism

What type of anemia is characterized by low MCV, low MCH, and low MCHC?

Iron deficiency anemia Signup and view all the answers

Which of the following conditions may lead to decreased red blood cell production due to nutritional deficiencies?

Vitamin B12 deficiency Signup and view all the answers

Which of the following is a cause of anemia related to chronic disease?

Chronic inflammatory diseases Signup and view all the answers

Which of the following describes sideroblastic anemia?

Accumulation of iron in red blood cell precursors Signup and view all the answers

Which genetic disorder is primarily associated with reduced or defective hemoglobin production?

Thalassemia Signup and view all the answers

What change is not typically observed in patients with iron deficiency anemia (IDA)?

Increased serum ferritin levels Signup and view all the answers

Which of the following is NOT a cause of iron deficiency anemia (IDA)?

Malnutrition with sufficient iron intake Signup and view all the answers

Which symptom is commonly associated with iron deficiency anemia?

Painless glossitis Signup and view all the answers

What distinctive neurobehavioral complication can occur in patients with IDA?

Pica Signup and view all the answers

What laboratory finding is characteristic of iron deficiency anemia?

High total iron binding capacity (TIBC) Signup and view all the answers

Which of the following statements about investigations for IDA is true?

Upper GIT endoscopy can be a part of the investigation Signup and view all the answers

Which statement regarding anemia of chronic diseases is accurate?

It results in normochromic normocytic or mildly hypochromic microcytic RBCs Signup and view all the answers

What is the relationship between ferritin and anemia in IDA?

Ferritin levels can indicate depleted iron stores before anemia occurs Signup and view all the answers

Study Notes

Anemia Lecture Notes

Anemia is a condition caused by insufficient healthy red blood cells to carry adequate oxygen to tissues.
Causes of anemia can be broadly categorized into three groups:
- Decreased red blood cell production
- Increased red blood cell destruction (hemolysis)
- Blood loss (acute or chronic)
- Other causes (e.g., infection, alcoholism, drugs)

Decreased Red Blood Cell Production

Nutritional deficiencies are a cause, including:
- Iron deficiency (most common worldwide)
- Vitamin B12 deficiency (pernicious anemia)
- Folate (vitamin B9) deficiency
Chronic diseases can also cause decreased production:
- Chronic kidney disease (insufficient erythropoietin production)
- Chronic inflammatory diseases (e.g., rheumatoid arthritis, lupus)
- Cancer
Endocrine disorders, such as hypothyroidism and hypopituitarism can also impact production
Bone marrow disorders, including aplastic anemia, myelodysplastic syndromes, leukemia, or lymphoma
Genetic disorders, like thalassemia (reduced or defective hemoglobin production)

Hypochromic Microcytic Anemia

Characterized by low Mean Corpuscular Volume (MCV) and low Mean Corpuscular Hemoglobin (MCH) & Mean Corpuscular Hemoglobin Concentration (MCHC).
Differential diagnosis includes:
- Iron deficiency anemia
- Anemia of chronic diseases
- Thalassemia
- Sideroblastic anemia and lead poisoning

Definition of Iron Deficiency Anemia

Defined as a decreased total iron body content.
Occurs when iron deficiency is severe enough to diminish erythropoiesis (red blood cell production) and cause anemia.
Iron deficiency without anemia is more common than Iron deficiency anemia.

Iron Deficiency Anemia (IDA)

Most common cause of anemia worldwide.
Also the most important cause of microcytic hypochromic anemia.
IDA is characterized by reduced values in all three red blood cell indices (MCV, MCH, MCHC) and peripheral blood smear (PBS) shows microcytic, hypochromic red blood cells due to a problem in hemoglobin synthesis.

Causes of Iron Deficiency Anemia (IDA)

Chronic blood loss (uterine or gastrointestinal bleeding, rarely urinary).
Increased demands (pregnancy, growth, prematurity, and childbearing).
Malabsorption (gastrectomy or celiac disease).
Poor diet.

Symptoms and Physical Findings of Iron Deficiency Anemia (IDA)

In early stages, there are often no symptoms.
Symptoms are similar to low hemoglobin (Hb), including palpitations, shortness of breath (dyspnea), headache, and dizziness.
Physical examination may reveal:
- Painless glossitis (inflammation of the tongue)
- Angular stomatitis (inflammation at the corners of the mouth)
- Brittle spoon nails (koilonychia)
Pica (compulsion to consume non-foodstuffs like ice or clay) may occur.

Laboratory Findings of IDA

Complete blood count (CBC): Low hemoglobin (Hb) and low mean corpuscular volume (MCV).
Peripheral blood smear (PBS): Shows microcytic, hypochromic red blood cells, possibly with target cells, or pencil-shaped cells.
Platelets are often moderately elevated
Bone marrow aspirate is not usually necessary except in complicated cases

Serum Iron and Total Iron Binding Capacity (TIBC)

Serum iron is low in IDA.
Total iron-binding capacity (TIBC) is high in IDA.
Serum ferritin is very low.
Serum transferrin is low.
Prussian blue-stained bone marrow specimen confirms iron depletion.

Investigation for IDA

Clinical history
Physical and rectal examination
Upper gastrointestinal (GI) endoscopy
Sigmoidoscopy
Examination for hookworm ova
Urine analysis for hematuria

Anemia of Chronic Diseases

Features:
- Normochromic or mildly hypochromic, normocytic or microcytic red blood cells.
- Mild, non progressive anemia (Hb usually not less than 9 g/dL).
- Serum iron is usually reduced.
- Serum ferritin is normal or elevated.
- Bone marrow (BM) iron stores are usually normal.

Pathogenesis of Anemia of Chronic Diseases

Decreased iron release from macrophages (MQ) to plasma.
Reduced red blood cell (RBC) lifespan.
Inadequate erythropoietin response to anemia.
The anemia is not usually responsive to iron therapy.

Sideroblastic Anemia

A group of blood disorders characterized by impaired incorporation of iron into hemoglobin, even with adequate iron stores.
Results in iron accumulation in mitochondria of developing red blood cells, forming ringed sideroblasts.
May be congenital or acquired.
Key features include: ringed sideroblasts in the bone marrow, microcytic or normocytic anemia (often with hypochromia), elevated serum iron and ferritin, and low transferrin saturation.

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Description

Explore the intricacies of anemia including its causes, types, and effects on the human body. This quiz covers nutritional deficiencies, chronic diseases, and other contributors to decreased red blood cell production. Test your knowledge on this crucial medical condition.