Hematology - Anemia
Pathophysiology
Types of Anemia
Treatment
Definition
Reduction in RBC, hemoglobin content or both
S&S
Pallor
Respiratory SOB
Fatigue
Yellowing of skin
Cold hands and feet
Headache and dizziness
Iron deficient anemia (Microcytic)
Lack of iron in blood
Absorption - lack in diet/poor absorption
Production - pregnancy or heavy menses
Gastric bypass surgery
Aplastic anemia
Insufficient production of RBC
Viral infection
Drug induced/toxic chemicals
autoimmune disease
Idiopathic
Megaloblastic anemia
Folic acid, B12 deficiency
Pernicious - poor B12 absorption
Hemolytic anemia
RBC breakdown in bloodstream
Viral infection, drugs. autoimmune disease, congenital abnormalities
Inherited abnormalities
affect hemoglobin or RBC shape
Thalassemia, G6PD
Sickle cell anemia
Defect in hemoglobin structure
Rigid RBC, clogs circulation
cannot enter small vessels
Others
Kidney failure
Lack of erythropoietin
Chemotherapy
Reduction in RBC production
Differential Diagnosis from
Other diseases
Hypothyroidism
Depression
CCF
Pulmonary causes of SOB
Chronic Fatigue Syndrome
Definitive S&S
Pallor and jaundice (hemolytic)
Systolic flow murmur
Glossitis
Angular cheilosis
Ataxia, positive Romberg sign
Tachycardia
Loss of vibrational and joint position sense
Iron Deficiency
Iron supplement, diet change
If bleeding, need to stop underlying cause - may need surgery
Megaloblastic anemia
Supplementation and diet change
B12 injections e.o.d for pernicious anemia
Chronic disease anemia
Treat underlying cause
If severe, consider transfusion and EPO injections
Aplastic anemia
Blood transfusion
If severe, bone marrow transfusion
Bone marrow disease
Medication, chemotherapy, bone marrow transplant
Hemolytic anemia
Avoiding food, treating disease and immunosuppresants
Blood transfusion, plasmapheresis, splenectomy
Sickle cell anemia
Administer O2, pain-relievers, oral and IV fluid to reduce pain
Blood transfusion, folic supplements, antibiotic
Bone marrow transplant, hydroxyurea
Thalassemia
Medication, chemotherapy, bone marrow transplant, splenectomy, folic supplements
IV Iron administration
GI bleeding
Cannot absorb iron
Irritable bowel syndrome
Irritate bowels
Kidney dialysis
Blood loss, increase iron demand due to ESA
Patients to undergo high blood loss surgery
Celiac disease (gluten intolerance)