hx of known chronic inflammatory, autoimmune, or infectious states; sustained physiological stress, renal failure; vasculitis or collagen vascular diseases, poor exercise tolerance; anaemia correlates with severity of inflammatory process; Exam: pallor, fatigue, dyspnoea. Malignancy: ALL: malaise, fatigue, easy bruising or bleeding, recurrent infections, fever, arthralgias, infection, anorexia, night sweats, shortness of breath, bony tenderness, epistaxis, bleeding gums, gingival hyperplasia; Exam: pallor, petechiae, purpura, tachycardia, hepatosplenomegaly, lymphadenopathy, painless scrotal enlargement, bleeding gums. AML: history of prior chemotherapy or radiotherapy; malaise, night sweats, fatigue, easy bruising or bleeding, recurrent infections, fever, bony tenderness, epistaxis, bleeding gums, gingival hyperplasia; Exam: pallor, petechia, purpura, dyspnoea, tachycardia. CML: usually in middle-aged patients; fatigue, weight loss, night sweats, early satiety, petechiae, purpura, recurrent fevers, bone pain, gouty arthritis; Exam: tender splenomegaly, painful sternum, lymphadenopathy, splenomegaly. Hairy cell leukemia: weakness, fatigue, weight loss, night sweats, early satiety, petechiae, purpura, recurrent fevers, abdominal discomfort or fullness due to large spleen; Exam: massive splenomegaly. Acquired aplastic anemia: history of hepatitis, HIV, benzene exposure, use of known causative medications, radiation exposure, paroxysmal nocturnal haemoglobinuria; malaise, fatigue, easy bruising or bleeding, recurrent infections, fever; Exam: pallor, petechiae, purpura, dyspnoea, tachycardia. RA, SLE, connective tissue disorders, chronic infection--viral hepatitis: perinatal exposure, direct body fluid transmission, exposure to food-borne outbreak (in hepatitis A); nausea, vomiting, abdominal pain, fever, malaise, fatigue and headache, dark urine, acholic (clay-coloured) stools, jaundice, pruritus (in hepatitis B); hepatitis C is usually asymptomatic; Exam: jaundice, hepatomegaly, RUQ pain, acholic stools, maculopapular or urticarial skin rash (in hepatitis B); usually normal in hepatitis C. Chronic renal failure-->low EPO: poor exercise tolerance; features of secondary hypoparathyroidism: muscle cramps, bone pain; Exam: pallor, fatigue, dyspnoea; signs of renal failure: jaundice, skin bruising, lung rales, pericardial rub, oedema, poor concentration or memory, myoclonus; positive Chvostek's sign or Trousseau's sign in associated hyperparathyroidism. excessive trauma