Anemia .pdf

 Dr. Seyedamir Sheikholeslami Hematologist Oncologist Imam Hossein Hospital Shahid Beheshti University of medical science women in Post meno pause Approach to Anemia Aboutvo 13 in Ok. The...

 Dr. Seyedamir Sheikholeslami Hematologist Oncologist Imam Hossein Hospital Shahid Beheshti University of medical science women in Post meno pause Approach to Anemia Aboutvo 13 in Ok. The World Health Organization (WHO) defines anemia as a hemoglobin level < 13 gr/dl in men and < 12 gr /dl in women. Loading… The mean hematocrit value for adult males is 47% (standard deviation, ±7%) and that for adult females = is 42% (±5%). Hematocrit levels are less useful than hemoglobin levels in assessing anemia because they are = Hb is better than Hop calculated rather than measured directly.-  CLINICAL PRESENTATION OF ANEMIA - Signs Chromi PALPITATION'S FATIGUe Pain Anemia is most often recognized by abnormal Reset un good. screening laboratory tests. Acute anemia is due to blood loss or hemolysis. - G (sepsis) - GI - Menstration - ↓ - blood Pressure - 2-3 unit donen - Depletation of the blood. -  In the anemic patient, physical examination may demonstrate a forceful heartbeat, strong peripheral pulses, and a systolic “flow” murmur.IACHY CARDIA mouth Conjuctivita , m i n e - Loading… The skin and mucous membranes may be pale if the hemoglobin is 200 µg/L means there is at - - least some iron in tissue stores. for inflammation. good Causes of Iron Deficiency -  rocarpumpuzzem enoperate & - Phentoeme Diagnosis of Microcytic Anemia - cause t - nuclear defet AmiloDisPLASIA - Normal blood smear (Wright stain) NBC. > - Hypochromic microcytic anemia of iron deficiency Is in size It smaller - RBC than 10 MCU under ↓ Microcytic Anemia g Target cells > - we see this in Hemalobiu pathy  Severe iron-deficiency anemia. Levch Is Platfelt Blood SMEAR 13 Plat Meripheral = - some RBL Smaller serve Iron definea bore normal range. nucleos than - than RBC bigger some nuckorks Love - Dimorphism patient : transfusion Smaller Smaller Re = than lymposite  TREATMENT The severity and cause of iron-deficiency anemia will determine the appropriate approach to treatment. symptomatic elderly patients with severe iron- deficiency anemia and cardiovascular instability may require red cell transfusions. Younger individuals who have compensated for their anemia can be treated more conservatively with iron replacement. The foremost issue for the latter patient is the precise identification of the cause of the iron deficiency.  RED CELL TRANSFUSION Blood transfusion 1st Step is Transfusion therapy is reserved for individuals who have symptoms of anemia, cardiovascular instability, and continued and excessive blood loss from whatever source and who require immediate intervention.  ORAL IRON THERAPY with Tablet 1 200 ma iron > - but Each n doueood The asymptomatic patient with established iron- deficiency anemia and an intact gastrointestinal Loading… tract, treatment with oral iron is usually adequate.  Typically, for iron replacement therapy, up to 200 mg of elemental iron per day is given, usually as three or four iron tablets (each containing 50–65 mg elemental iron) given over the course of the day. Ideally, oral iron preparations should be - taken on an empty stomach, since food may - - inhibit iron absorption. -  Patients with gastric disease or prior gastric surgery require special treatment with iron - solutions because the retention capacity of the stomach may be reduced.  Treatment should continue 6-12 month - The goal of therapy in individuals with iron- deficiency anemia is not only to repair the anemia, but also to provide stores of at least 0.5– 1 g of iron. Sustained treatment for a period of 6– 12 months after correction of the anemia will be necessary to achieve this. -  complications of oral iron therapy, gastrointestinal distress is the most prominent and is seen in at least 15–20% of patients. = Abdominal pain, nausea, vomiting, or constipation may lead to noncompliance. The absence of a response may be due to poor absorption, noncompliance (which is common), or - a confounding > - diagnosis. of complic game.  & A useful test to determine the patient’s ability to absorb iron is the iron tolerance test. Two iron tablets are given to the patient on an empty stomach, and the serum iron is measured - - serially over the subsequent 2–3 h. Normal - absorption will result in an increase in the serum - iron of at least - 100 µg/dL.  Response to iron therapy Typically, the reticulocyte count should begin to increase within 4–7 days after initiation of therapy and peak at 1–1½ weeks. /  PARENTERAL IRON THERAPY Body weight (kg) × 2.3 × (15 – patient’s hemoglobin, g/dL) + 500 or 1000 mg (for stores).