Week 1: Microcytosis Anemia classification Anemia classification Micro-Hypo anemia Micro-Hypo anemia CBC and histogram CBC and histogram IDA IDA Fe metabolism.

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Presentation transcript:

Week 1: Microcytosis Anemia classification Anemia classification Micro-Hypo anemia Micro-Hypo anemia CBC and histogram CBC and histogram IDA IDA Fe metabolism Fe metabolism Fe studies Fe studies Hb electrophoresis Stem cell theory RBC precursors EPO, IL’s, cytokines Erythropoiesis

RBC Precursors and Stem Cell Theory Rubriblast = Pronomoblast Rubriblast = Pronomoblast Prorubricyte = Basophilic Nbl Prorubricyte = Basophilic Nbl Rubricyte = Polychromatic Nbl Rubricyte = Polychromatic Nbl Metarubrucyte = Orthochromatic Nbl Metarubrucyte = Orthochromatic Nbl Reticulocyte Reticulocyte Erythrocyte Erythrocyte

Erythropoiesis

Rubriblasts to metarubricyte

Metarubricyte

Reticulocytes

Sign and Symptoms of Anemia CBC: H&H, RBC, indices, morphology CBC: H&H, RBC, indices, morphology Pallor Pallor Weakness, dizziness, hypotension Weakness, dizziness, hypotension Jaundice (if hemolytic) Jaundice (if hemolytic) Koilonychia in IDA Koilonychia in IDA Peripheral neuropathy with magaloblastic Peripheral neuropathy with magaloblastic X-ray changes (eg, thalassemia) X-ray changes (eg, thalassemia) Splenomegaly, hepatomegaly (extramedullary) Splenomegaly, hepatomegaly (extramedullary)

Morphologic Classification Normocytic Normochromic Normocytic Normochromic Microcytic Hypochromic Microcytic Hypochromic Macrocytic Macrocytic

Physiologic Classification Hemorrhage (acute vs chronic) Hemorrhage (acute vs chronic) Proliferation defect (eg, aplastic) Proliferation defect (eg, aplastic) Maturation defect (eg, metabolic, hemoglobinopathy) Maturation defect (eg, metabolic, hemoglobinopathy) Hemolytic Hemolytic

Microcytic Hypochromic Anemia Low MCV Low MCV Morphologic clues Morphologic clues Iron deficiency anemia Iron deficiency anemia Anemia of chronic disease Anemia of chronic disease Porphyria Porphyria Hemoglobinopathies Hemoglobinopathies

Hemoglobin Synthesis

Iron Deficiency Anemia Fe metabolism and heme synthesis Fe metabolism and heme synthesis Dietary deficiency Dietary deficiency Chronic blood loss Chronic blood loss Vitamin C deficiency Vitamin C deficiency Serum Fe, ferritin, TIBC, % saturation Serum Fe, ferritin, TIBC, % saturation SSx of anemia, koilonychia, pica SSx of anemia, koilonychia, pica Tx and CBC changes Tx and CBC changes

Iron Deficiency Anemia CBC Report

IDA bone marrow

IDA After Treatment