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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
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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
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Erythropoiesis
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Rubriblasts to metarubricyte
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Metarubricyte
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Reticulocytes
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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)
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Morphologic Classification Normocytic Normochromic Normocytic Normochromic Microcytic Hypochromic Microcytic Hypochromic Macrocytic Macrocytic
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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
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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
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Hemoglobin Synthesis
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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
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Iron Deficiency Anemia CBC Report
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IDA bone marrow
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IDA After Treatment
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