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Q.1) What does Anemia mean?

Ans : Decrease in the oxygen carrying capacity of the blood is termed as anemia.

Anemia is divided into following types

  • Megaloblastic Anemia.                 More...

  • Hemolytic Anemia.                           More...

  • Aplastic Anemia.                                    More...

  • Iron Deficiency Anemia.                                 More...

  

Q.2) Whom does it affect the most?

Ans: Anemia can occur at any age, but people at the extremes of age are more susceptible. Females (especially in the age group of 15-45) are more prone to anemia.

 

Q.3) How does Anemia progress?
Ans: Reduction below normal of 
  • The number of erythrocytes (Red Blood Corpuscles), 
  • Quantity of haemoglobin (Hb), or 
  • The volume of packed red blood cells (Red Blood Corpuscles) in the blood.
  
Q.4) What are the causes of Anemia?
Ans: Anemia results from one or more combinations of three basic factors:-
  • Blood loss.
  • Decreased Red Blood Corpuscles(RBC) production, or
  • Increased RBC destruction (hemolysis).
Classification
Anemia can be broadly categorized into three major classifications according to the size or mean corpuscular volume (MCV) of the erythrocytes (RBCs).
 
A) Microcytosis (decreased MCV)
  • Iron deficiency anemia
  • Alpha or beta thalassemia
  • Anemia of chronic diseases, chronic inflammation or infection
  • Sideroblastic anemia
B) Normocytosis (normal MCV)
  • Normal variant.
  • Anemia of chronic disease.
  • Acute haemorrhage (bleeding).
  • Endocrinopathies
    • myxedema (decrease in thyroid function),
    • Addison's disease (deficient secretion of adrenocortical hormones)                                                             
  • HIV-related anemia.
  • Dilutional anemia
  • Mixed anemia: the presence of two or more causes. 
  • Myelophthisic anemia: replacement of the normal marrow cells by leukemic, myeloma, or metastatic cancer cells or by myelofibrosis.
  • Liver disease like:
    • hepatitis.
    • cirrhosis.
  • Uremia: history of renal dysfunction;
  • Hemoglobinopathies
C) Macrocytosis (increased MCV)
  • Pure red cell aplasia
    • Drug-induced 
    • Underlying malignancies (thymoma, lymphoma),
    • Viruses (parvovirus B19).
  • Alcoholism
  • Aplastic anemia
    • bone marrow failure resulting from 
      • Drugs 
      • Radiation
      • Viral infections
      • Hereditary (Fanconi's anemia).
  • Paroxysmal nocturnal hemoglobinuria (PNH).
  • Myelodysplastic syndromes
  • Megaloblastic anemias: B12 or folate deficiency.
  • Hemolytic anemias: Characterized by an excessive destruction of Red Blood Corpuscles.
    They are:-
a. Extrinsic
  • Antibody-mediated: immunohemolytic anemia 
  • Microangiopathic hemolytic anemias:
    • Thrombotic thrombocytopenic purpura (TTP)
    • Disseminated intravascular coagulation (DIC)
    • Hemolytic-uremia syndrome (HUS)
  • Toxins, malaria
b. Intrinsic
  • RBC membrance defects
    • Hereditary spherocytosis.
    • Hereditary elliptocytosis.
  • PNH
  • Hemoglobinopathies
    • sickle cell disease
    • thalassemia
  • Enzymopthies: G6PD deficiency, pyruvate kinase deficiency
Q.5)What are the symptoms of Anemia?
Ans: The symptoms of anemia are
  • Weakness
  • Headaches
  • Dizziness
  • Fatigue.
If the anemia develops slowly, the patient maybe asymptomatic.
  
Q.6)What are the signs of Anemia?  
Ans: The Signs are
  • On physical examination: Orthostatic hypotension,
  • Tachycardia
  • Tachypnea
  • Jaundice and hepatosplenomegaly 
  • Neurologic manifestations, such as loss of vibratory or positional sensation
  • Evidence of underlying disease as cause for the anemia.
Q.7)What investigations are conducted?
Ans: Laboratory tests conducted are
  • Serum iron
  • Total iron-binding capacity (TIBC), and
  • Serum ferritin
  • Transferring saturation
  • Haemoglobin electrophoresis 
  • Free erythrocyte protoporphyrin (FEP).
  • Check feces for occult blood.
  • Serum B12.
  • Folate levels.
  • Thyroid function tests.
  • Complete blood count (CBC) with differential and platelet count.
  • Reticulocyte count.
  • Peripheral smear.
  • Bone marrow biopsy and/or aspirate, if required.
  • Investigations specific for underlying disease, if any.

 

 

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