Anemia and Polycythemia - King Saud University - PDF

7 Anemia and Polycythemia Red: Important Black: In Male & Female slides Blue: In male slides Pink: In female slides Gr...

7 Anemia and Polycythemia Red: Important Black: In Male & Female slides Blue: In male slides Pink: In female slides Green: Notes & extra information Team Leaders: Haya Alenazi Abdulrahman Alswat 1  Objectives -Define and classify anemia and explain its assessment -Describe the physiological consequences and clinical picture of anemia - Recognize the different types and causes and symptoms of anemia -Know how to differentiate between the different types and causes of anemia -Know the blood indices, their normal values and how to calculate them - Define and classify polycythemia - Describe the physiological consequences of polycythemia -Recognize causes of polycythemia. Anemia Definition: Decrease the number of RBC Below the normal Decrease HB level of the same Oxygen supply to tissues age & Gender Major causes of anemia: 1- Decrease RBC production 2-Increase RBC destruction Symptoms - depending on the severity - : 3- RBC loss without RBC destruction - Pale skin (pallor) - Fatigue + Weakness + Tiring easily - Breathlessness (tachypnea)+ Racing heart or palpitations (tachycardia) - Cold intolerance - Reduce in oxygen carrying capacity lack of O2 for ATP and heat production - Postural (orthostatic) hypotension: Drop in blood pressure when standing from a sitting or lying position – this may happen after acute blood loss, like a heavy period Signs: Koilonychia: is when the nail curves upwards (becomes spoon-shaped) Angular stomatitis: deep cracks and splits form at the corners of the mouth Tachycardia and tachypnea: due to compensatory sympathetic stimulation.  Causes of anemia RBC loss without RBC Decreased RBCs production Destruction of RBCs destruction Haemolytic anemia (Hemorrhage) Nutritional Increased deficiency demands Renal disease Bone marrow Intrinsic Extrinsic Causes: Types: failure Abnormalities Abnormalities Iron deficiency lack of Aplastic anemia (childhood & erythropoietin Microcytic pregnancy) Hereditary - Trauma Acute: hypochromic production Infections RBCs return to normal 3-6 W - irradiation or Thalassemia - Disorders: e.g. normocytic excessive X-ray Malaria Cancer, ulcer normochromic usage. Spherocytosis Chronic: - invasion of Vit. B12 & folic acid bone marrow by Mycoplasma Iron deficiency deficiency (secondary anemia cancer cells or - Menstruation fibrosis). Incompatible blood -Gynecological transfusion disorders - GIT bleeding - drugs e.g. (peptic ulcer- chloramphenicol Bilharziasis- piles-hookworms). Erythroblastosis Microcytic hypochromic fetalis -Enzymatic defect (G6PD deficiency)  Types of anemia Microcytic hypochromic Normocytic normochromic Megaloblastic or macrocytic Decrease in Hb content, RBCs count, PCV(HCT value) Causes: Folic acid (folate) or vit Causes: Iron deficiency Causes: Acute blood loss B12 deficiency - microcytic = smaller size - Normal HB (in each RBC) - The hypersegmented - hypochromic = less hemoglobin - normal RBCs’ size. neutrophil and also that the - increased zone of central pallor - normal MCV and MCH RBC are almost as large as the -decrease in MCV and MCH lymphocyte. - anisocytosis = variation in size The decrease in the RBCs count will lead to decrease the total number of Hb in the - There are fewer RBCs. -poikilocytosis= variation in shape blood - increase in MCV and MCH Haematological indices Indices Male Females Hematocrit (Hct) (%) 47 42 Red blood cells (RBC) (106/L) 5.6 4.8 Hemoglobin (Hb) (g/dL) 16 14 Mean corpuscular volume (MCV) (fL) 90-95 Mean corpuscular hemoglobin (MCH) (pg) 29 Mean corpuscular hemoglobin concentration (MCHC) (g/dL of cells) 34  MCV is the most accurate method of Haematological indices measuring red blood cells and most useful in classification of anemia (MCV) The average Expressed in ↑ 95 fl : Macrocytic anemia Mean corpuscular volume of the femtoliters (fL) or Normal value ( 90-95 fl ): normocytic anemia volume RBCs cubic micrometers. ↓ 90 fl : Microcytic anemia (MCH) The average Expressed in ↑ 33 pg: Hyperchromic Mean corpuscular Hb amount of picograms (pg) Normal value ( 27-33 pg ): normochromic hemoglobin ↓ 27 pg: Hypochromic inside a RBC (MCHC) The average expressed as Mean corpuscular concentration (gm/dl) Normal value ( 32-36 g/dl ) of RBCs concentration of hemoglobin in the RBCs Reticulocytes are immature red ↑ 2% excessive RBC destruction or loss (Hemolytic Reticulocyte index blood cells (RBCs) anemia) ↓ 2% decreased production (Aplastic anemia) Indices Hematocrit (Hct) RBC Hb MCV MCH MCHC Male 47% 5.6x106/L 16 g/dL 90-95 fl 29 pg 34 g/dL of 6 cells Females 42% 4.8x10 /L 14 g/dL Polycythaemia Definition: Increase in the number of RBCs per unit volume of blood Classification & Causes Relative True or absolute In cases of dehydration Hypoxia: deficiency in the (haemoconcentration) amount of oxygen reaching the tissues decrease in the Primary (polycythaemia Rubra Secondary due to hypoxia volume of plasma vera - PRV) ‫ﯾﺳﻣﻰ ﺳﻛﻧدري ﻷن ﺑﺎﻟﺑداﯾﺔ ﺗﺣدث اﻟﮭﺎﯾﺑوﻛﺳﯾﺎ‬ Uncontrolled RBC production ‫وﺑﻌدھﺎ ﯾﺣدث زﯾﺎدة ﻓﻲ إﻧﺗﺎج‬ (cancer of the bone marrow) RBCs More in female QUIZ! MCQs SAQ Q1: which type of Anemia has RBC's are smaller than normal? Q1: what are the symptoms of Anemia? - Only 2 - A) Aplastic anemia B) Microcytic hypochromic C) Megaloblastic Anemia D) Hemolytic anemia anemia Q2: What Are the Classification of Polycythaemia? Q2: Which of the following is correct about normocytic normochromic anemia : A) decrease in MCV and B) increase in MCV and C) normal MCV and MCH D) normal RBCs count MCH MCH 4) A Q3: Increased demands of RBCs - like during childhood & pregnancy - will lead to : 3) A 2) C 1) B MCQs key answer : A) Increased RBCs B) Destruction of RBCs C) Blood less D) Decreased RBCs production production 2) 1- Relative. 2- True. palpitations Q4 : iron deficiency is the major cause of : - Breathlessness + Racing heart or - Fatigue + Weakness + Tiring easily 1) Pale skin A) Microcytic hypochromic B) Normocytic normochromic C) Macrocytic anemia D) Sickle cell anemia SAQ answer key : anemia anemia  ‫‪Thank You‬‬ ‫‪Team members:‬‬ ‫▷‬ ‫ﺣﺻﺔ اﻟﻌﻠﯾﺎن‬ ‫▷‬ ‫أﺣﻣد اﻟﺧﯾﺎط‬ ‫▷‬ ‫ﺷذى اﻟظﮭﯾر‬ ‫▷‬ ‫ﻣﺎﺟد اﻟﻌﺳﻛر‬ ‫▷‬ ‫ﺳﻣو اﻟزﯾر‬ ‫▷‬ ‫ﻣﺷﻌل اﻟﺛﻧﯾﺎن‬ ‫▷‬ ‫ﻧورة اﻟﺷﺛري‬ ‫▷‬ ‫ﻋﺑداﻟﻌزﯾز اﻟرﺑﯾﻌﺔ‬ ‫▷‬ ‫ﺳﺎرة اﻟﻘﺣطﺎﻧﻲ‬ ‫▷‬ ‫ﺑﺎﺳل ﻓﻘﯾﮭﺎ‬ ‫▷‬ ‫رﯾﻧﺎد اﻟﺣﻣﯾدي‬ ‫‬ ‫‪Made by‬‬ ‫▷‬ ‫ﻣﺣﻣد ﺑﯾﺎري‬ ‫▷‬ ‫ﯾﺎﺳﻣﯾن اﻟﻘرﻧﻲ‬ ‫▷‬ ‫ﻣﺣﻣد اﻟﺳﻠﻣﺎن‬ ‫▷‬ ‫ﯾﺎرا اﻟزھراﻧﻲ‬ ‫▷‬ ‫ﻋﺑداﻟرﺣﻣن اﻟدوﯾش‬ ‫▷‬ ‫ﻟﻣﻰ اﻷﺣﻣدي‬ ‫‪Contact info:[email protected]‬‬ ‫▷‬ ‫ﻣرﺷد اﻟﺣرﺑﻲ‬ ‫▷‬ ‫آﻻء اﻟﺳﻠﻣﻲ‬ ‫▷‬ ‫ﻣﻧﯾب اﻟﺧطﯾب‬ ‫▷‬ ‫ﺳﺎرة اﻟﻌﯾدروس‬ ‫▷‬ ‫ﻧﺎﯾف اﻟﺷﮭري‬ ‫‪Editing file‬‬ ‫▷‬ ‫ﺑدور اﻟﻣﺑﺎرك‬ ‫▷‬ ‫ﻓﯾﺻل اﻟﻌﻣري‬ ‫▷‬ ‫ﻓرح اﻟﺑﻛر‬ ‫▷‬ ‫ﻋﺑداﻟﻌزﯾز اﻟﻐﻠﯾﻘﺔ‬ ‫▷‬ ‫ﺳﺎرة اﻟﻌﺑﯾد‬ ‫‪Physiology 439 file‬‬ ‫▷‬ ‫ﻋﺑداﻟﻌزﯾز اﻟﺳﺣﯾم‬