Differentiation of Anemia

58 Pages·2013·1.17 MB·English

Differentiation of Anemia
KY STOLTZFUS, MD
ASSISTANT PROFESSOR, INTERNAL MEDICINE
UNIVERSITY OF KANSAS MEDICAL CENTER
JANUARY 23, 2013
Differentiating Anemia
 Anemia is a sign of a disease process or problem
But anemia has consequences if left untreated…

When you have a sign

Look further and investigate cause

Chronic affects of anemia
Anemia, physiological impairments, and clinical outcomes. Anemia has
been linked to a number of physiological impairments and clinical
outcomes in community-dwelling older populations.
RBCs
 Red Blood Cell
Adults have approx. 20-30 trillion RBCs in circulation

Each having over 200 million molecules of hemoglobin

Each hemoglobin molecule has 4 heme molecules that carry

oxygen molecule
Flexible so can fit through tiny capillary spaces to offload

oxygen.
RBC production
RBCs
 Life cycle of RBC
50,000 reticulocytes produced daily

Reticulocyte circulates for about 1 day

RBC survives approx. 110-120 days

Removed by reticuloendothelial system

Iron recycled to make new RBCs

Under normal conditions about 1% of RBC’s removed daily

Anemia
 Anemia
Reduction in red blood cell mass

NOT just a drop in Hgb lab value

 Definition
World Health Organization

<13 g/dL males

<12 g/dL females

Prevalence of anemia:
3.6 million people in US
Differential Diagnosis of Anemia
 Signs/symptoms – how is anemia found?
Depends on:

severity

rate of onset

etiology

patient’s overall health & oxygen demand

Differential Diagnosis of Anemia
 Diagnosis
Past medical history

Family history

Physical exam

Lab
