Medicine 5th year, 5th & 6th lectures (Dr. Sabir)
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The lecture has been given on Feb. 27th & Mar. 26th, 2011 by Dr. Sabir.
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Medicine 5th year, 5th & 6th lectures (Dr. Sabir)
- 1. Approach to the Patient with ANEMIA Dr. SABIR
- 6. Not pale conjunctiva Pale conjunctiva
- 35. Heinz body
Notas do Editor
- Limitations-1. Given that these ranges include 95% of the normal population, the 2.5% of normal subject with values which fall below the normal range will be arbitrarily depicted as being anemic 2. The normal range for HGB and HCT is so wide that, for example a male patient with a baseline HCT of 49% may lose up to 15% of his RBC mass through hemolysis or blood loss and still have a HCT within the normal range
- CBC-red cell indices-size-micro,macro, normo, color(chromasia) WBC-leukopenia should alert to bone marrow suppression Differential-immature forms Retic count-high-indicates increased response to continued hemolysis or blood loss stable anemia w/ low retic is strong evidence for deficient production of RBCs (reduced marrow response) Smear-as above, nuceated RBCs hematologic dz(sickle, thal,hemolytic anemia), things missed by automated counters: schistocytes, RBC parasits, evidence for hemolysis
- Primary Bone Marrow involvement Marrow dysfunction vs. Marrow infiltration
- Note hypersegmented polys – B12 & folate deficiency
- AKA: hemolytic anemias
- Ferritin sen=90% spec=80%