1. 빈혈 anemia 빈혈 anemia

2. 혈액 내에 들어 있는 헤모글로빈의 농도가 정상 수치보다 낮아진 상태 적혈구의 수 형태 이상

3. Red Blood Cells Carry Oxygen to Tissues Biconcave Disk Containing Hemoglobin Life Span of 120 days M : 4.5-5.5 x 10 12 RBCs/L F : 4.0-5.0 x 10 12 RBCs/L

4. Hemoglobin Oxygen Carrying Molecule Tetramer of 2 alpha chains and two “beta” chains (  2  2 ) attached to Heme pocket Heme comprised of protoporphyrin ring and iron Male :13~17 g/dl Female : 11~15 g/dl

5. 적혈구 용적률 Hematocrit Percentage of blood which is comprised of RBCs Male : 40-50% Female : 35-45%

6. 철 결핍성 빈혈 Iron deficiency Anemia 철 결핍성 빈혈 Iron deficiency Anemia

7. Iron Present No Iron Present

8. Increased Need Early childhood and adolescence (growth spurts) Pregnancy (extra 3.8 mg/day over baseline) Lactation Poor Intake/Absorption Milk baby Achlorhydria Inflammatory bowel disease

9. 철 결핍성 빈혈의 원인

10. ETIOLOGY Chronic Bleeding » Menorrhagia » Peptic ulcer » Stomach Cancer » Ulcerative Collitis » Intestinal Cancer » Hemorrhoids Decreased iron intake Increased iron requirment (Juvenileage, Pregnancy, Lactation)

11. IRON DEFICENCY - STAGES Prelatent – reduction in iron stores without reduced serum iron levels Latent – iron stores are exhausted, but the blood hemoglobin level remains normal Iron deficiency anemia – blood hemoglobin concentration falls below the lower limit of normal

12. GENERAL ANEMIA’S SYMPTOMS FATIGABILITY DIZZENES HEADACHE SCOTOMAS IRRITABILITY ROARING PALPITATION CHD, CHF

13. CHARACTERISTICS SYMPTOMS GLOSSITIS, STOMATITIS DYSPHAGIA ( Plummer-Vinson syndrome) ATROPHIC GASTRITIS DRY, PALE SKIN SPOON SHAPED NAILS, KOILONYCHIA, BLUE SCLERAE HAIR LOSS PICA (APETITE FOR NON FOOD SUBSTANCES SUCH AS AN ICE, CLAY) SPLENOMEGALY (10%) INCREASED PLATELET COUNT

15. 거대적혈모구성 빈혈 Megaloblastic Anemia 거대적혈모구성 빈혈 Megaloblastic Anemia

16. Cuuses of Megaloblastic Anemia

17. 용혈성 빈혈 Hemolytic Anemia 용혈성 빈혈 Hemolytic Anemia Easy fatigability Dyspnea on exertion Faintness/ Vertigo Pallor Rapidly bounding pulse Dependent edema Systolic murmurs

18. Hemoglobinopathy (e.g. sickle cell) Membrane Abnormality (e.g. hereditary spherocyosis) Enzyme Defect (e.g. G6PD deficiency) Autoimmune hemolytic anemia Trauma (e.g. DIC, TTP) Infection (e.g. malaria) Sickle Cell

19. Autoimmune Hemolytic Anemia

20. Speherocytosis

21. Enzyme Deficiencies