7

Anemia and

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 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 (childhood & Microcytic erythropoietin - Trauma pregnancy) production Hereditary Infections Acute: hypochromic RBCs return to normal 3-6 W - irradiation or - Disorders: e.g. normocytic excessive X-ray Malaria Cancer, ulcer normochromic usage. Spherocytosis - invasion of Chronic: 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 - 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 measuring red blood cells and most useful in Haematological indices classification of anemia

(MCV) The average Expressed in ↑ 95 fl : of the femtoliters (fL) or Normal value ( 90-95 fl ): volume RBCs cubic micrometers. ↓ 90 fl :

The average Expressed in ↑ 33 pg: Hyperchromic (MCH) 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 concentration Mean corpuscular (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 Females 42% 4.8x106/L 14 g/dL cells 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 ﯾﺳﻣﻰ ﺳﻛﻧدري ﻷن ﺑﺎﻟﺑداﯾﺔ ﺗﺣدث اﻟﮭﺎﯾﺑوﻛﺳﯾﺎ (volume of plasma vera - PRV وﺑﻌدھﺎ ﯾﺣدث زﯾﺎدة ﻓﻲ إﻧﺗﺎج Uncontrolled RBC production (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) D) 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 A 4)

A 3)

Q3: Increased demands of RBCs - like during childhood & pregnancy - will lead to : C 2)

1) B B 1) MCQs key answer : answer key MCQs

A) Increased RBCs B) Destruction of RBCs C) Blood less D) Decreased RBCs

production production True. 2- Relative. 1- 2)

palpitations palpitations

- Breathlessness + Racing heart or or heart Racing + Breathlessness -

Q4 : iron deficiency is the major cause of : easily Tiring + Weakness + Fatigue -

1) Pale skin Pale 1)

A) Microcytic hypochromic B) Normocytic normochromic C) Macrocytic anemia D) Sickle cell anemia : key answer SAQ anemia anemia Thank You

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