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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).
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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