1. Classification of anemia
Functional classification:
Hypoproliferative destruction (infective hematopoiesis).
Clinical classification:
Causes of anemia (blood loss, IDA, hemolysis).
Quantitative classification:
Hematocrit
Hemoglobin
Blood cell indices (MCV, MCH, MCHC).
Reticulocytes count.

2. Red cell indices MCV (mean corpuscular volume)
The average volume of RBC
Hct
=  10 (fl)
RBC count (m/µL)
e.g. Hct= 40%
RBC=5.0 (m /µL)
MCV= 40/5.0  10 = 80 fl
NR= fl

3. MCH (mean corpuscular hemoglobin)
The average content of Hb in average RBC.
It is directly proportional to the amount of Hb and RBC size. Hb
MCH =
 (pg)
RBC count (m/µL)
e.g. Hb = 14 g/dl
RBC = 4 (m/µL)
MCH= 14/4  10
= 35 pg
NR= pg

4. MCHC (mean corpuscular hemoglobin concentration)
Express the average concentration of hemoglobin per unit volume of RBC.
It defined as the ratio of the weight of hemoglobin to volume of RBC.
Hb (g/dl)
MCHC=
 (%)
Hct (%)
e.g. Hb = 14 g/dl
Hct = 45 %
MCHC 14/45  100 = 31%
NR= 32-36%

5. Hemoglobin/Hematocrit
Symptoms of Anemia
Normal or High
Hemoglobin/Hematocrit
Check other
Causes of symptoms
e.g. Cardiac Pulmonary
Low
RBC indices
MCV > 98
MCV < 80
MCHC < 32
MCV=80-96
History of acute blood loss
Auto immune Hemolytic anemia
Anemia of chronic Diseases
Anemia of infection
B12 and folate levels
Serum iron and Total Iron binding capacity of Ferritin
Low Iron
IDA, chronic diseases, Renal diseases
Normal
Hb electrophoresis for Thala.
High Iron
BM exam
For Sideroblastic anemia
Low B12
PA, GI problems
Severe malnutrition.
Low folate
Folate malnutrition
GI problems
Liver disease
High or Normal
MPD
Liver Disease

6. Normal red cell morphology

7. Hypochromic Hyperchromic
Macrocytic Microcytic

8. IDA
Target cells
Stomatocytes
Sickle cells
Poikiolocytosis
Acanthocytes
Spherocytes
Nucleated RBC
Ovalocyte