45-year-old Singaporean man at GP, lethargy for the last few months. Full blood count shows anaemia

Microcytic

Anemia of chronic disease (can be normocytic too)

Thal

Fe deficiency

Normocytic

Macrocytic

secondary to systemic cause e.g. liver, renal disease

BM failure

Megaloblastic

Folate

Pernicious, B12

Alcoholism

Liver disease

BM infiltration

Drugs: methotrexate, azithioprine

Blood loss

gastrointestinal (GI) hemorrhage

DIC

Hemolytic anemia

Physical trauma: prosthetic valve

Autoimmune

Drugs: quinine, dapsone, sulphonamides

Malaria

Mechanical

prominent schistocytes, including helmet cells and triangular cells, on the peripheral blood smear, elevation of the serum indirect bilirubin concentration, and reduction in the serum haptoglobin concentration.

tachycardia, tachypnea, chills, malaise, fatigue, diaphoresis (sweating), headache, cough, anorexia, nausea, vomiting, abdominal pain, diarrhea, arthralgias, and myalgias

active pulmonary tuberculosis), inflammatory (eg, rheumatoid arthritis), or malignant (eg, Hodgkin lymphoma)

fever, weight loss, anorexia, and malaise

Pica and ice craving, Beeturia, Restless leg syndrome, Dry or rough skin, Blue sclerae, Koilonychia, Cheilosis, Atrophic glossitis with loss of tongue papillae
low serum ferritin concentration, an increased total iron binding capacity (transferrin), and low serum iron concentration
Causes: Blood loss
Reduced iron absorption

  • Celiac disease/atrophic gastritis/H. pylori
  • Bariatric surgery

Hypothyroidism

Regular ingestion of 80 grams of alcohol each day (eg, one bottle of wine) is sufficient to cause this effect

Cirrhosis, Thrombocytopenia is the most common hematologic abnormality, while leukopenia and anemia

Aplastic anemia

fatigue, slow movement and slow speech, cold intolerance, constipation, weight gain, Hair may be coarse, hair loss is common, and the nails become brittle.

Epstein-Barr virus
Seronegative (non-A through -G) hepatitis
Human immunodeficiency virus (HIV)
Anticonvulsants: carbamazepine, hydantoins, phenacemide
Antibiotics: sulfonamides, chloramphenicol
Non steroidal anti-inflammatory drugs (NSAIDs): phenylbutazone, indomethacin
Anti-thyroid medications: methimazole, propylthiouracil

recurrent infections due to profound neutropenia or mucosal hemorrhage due to thrombocytopenia. Infections are typically bacterial, including sepsis, pneumonia, and urinary tract infection.

Substance abuse
Alcoholism
Poor dietary intake
Celiac disease (sprue)
Inflammatory bowel disease
Infiltrative bowel disease
Short bowel syndrome
Methotrexate
Trimethoprim
Ethanol

Pernicious anemia
Gastrectomy/bariatric surgery
Gastritis
Malabsorption syndrome
Ileal resection or bypass
Crohn's disease
Strict vegans

Sideroblastic anemia

congenital, lead exposure, medications

a. Macroangiopathic (marching, prosthetic valves)
b. Microangiopathic: disseminated intravascular coagulation (DIC), thrombotic
thrombocytopenic purpura (TTP), and hemolytic uremic syndrome (HUS) 4.
Infections, such as malaria

  1. Toxins, such as snake venom

Hematemesis (either red blood or coffee-ground emesis) suggests bleeding proximal to the ligament of Treitz. Blood originating from the left colon tends to be bright red in color, whereas bleeding from the right side of the colon usually appears dark or maroon colored

●Vascular: Hemorrhoids, Ischemic, Inflammatory:Infectious, Inflammatory bowel disease, Ulcer
Neoplastic: Polyp, Carcinoma
●Varices or portal hypertensive gastropathy in a patient with a history of liver disease or alcohol abuse
●Aorto-enteric fistula in a patient with a history of an abdominal aortic aneurysm or an aortic graft
●Angiodysplasia in a patient with renal disease, aortic stenosis, or hereditary hemorrhagic telangiectasia
●Peptic ulcer disease in a patient with a history of Helicobacter pylori, nonsteroidal anti-inflammatory drug (NSAIDs) use, or smoking
●Malignancy in a patient with a history of smoking, alcohol abuse, or H. pylori infection

AML: pancytopenia, pallor secondary to anemia, petechiae or ecchymoses secondary to thrombocytopenia or disseminated intravascular coagulation, excess bleeding or bruising, and infection ,marked reduction in red cells, platelets, and mature neutrophils