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Women and Anemia

Source: chhs.georgiasouthern.edu
Topic: Anemia
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Sort Desciption: V. Leigh Beasley, MD, FAAFP Normal Red Blood Cells Red Blood Cells Normal Peripheral Smear Definition of Anemia Males: Hgb. < 14 g/dl Hct. <42% Females: Hgb. <12 g/dl Hct. <37% 2 Laboratory Workup for Anemia Hct Hgb MCV MCHC Peripheral Smear Reticulocyte count Reticulocytes ...

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Women and Anemia What do all those numbers really mean? V. Leigh Beasley, MD, FAAFP Normal Red Blood Cells Red Blood Cells Normal Peripheral Smear Definition of Anemia Males: Hgb. < 14 g/dl Hct. <42% Females: Hgb. <12 g/dl Hct. <37% 2 Laboratory Workup for Anemia Hct Hgb MCV MCHC Peripheral Smear Reticulocyte count Reticulocytes Reticulocyte Index RI= Reticulocyte count X patient Hct/ Normal Hct Example: retic ct = 6% Patient Hct=15% RI = 6 X 15/45 = 2% Reticulocyte Index In bleeding or hemolysis, the RI is usually > or = 3% In decreased production, the RI is usually < 3% and often <1.5% Determining the type of anemia Mean Cell Volume (MCV) Microcytic MCV <80 femtoliters (fl) Normocytic MCV 80-100 fl Macrocytic MCV >100 fl Microcytic Anemia Iron deficiency Thalassemia Anemia of Chronic inflammation (occ) Sideroblastic anemia (rarely) Aluminum toxicity 3 Iron Deficiency Anemia Iron is stored in the spleen, liver and bone marrow Cell size (MCV) correlates with the degree of anemia MCHC can remain normal until Hct drops below 30% Etiology: Menses, pregnancy Iron Deficiency Anemia RI is low Serum Fe is low TIBC may be normal or elevated Serum Ferritin is usually low (more specific test that serum Fe or TIBC) Iron Deficiency Anemia If serum Ferritin is normal or elevated in the face of Fe def. anemia Acute liver disease/ cirrhosis Hodgkins disease Acute leukemias Fever/ acute inflammation Renal dialysis Recent Fe therapy Solid tumors (occ) Iron Deficiency Anemia Treatment Oral iron therapy Using less than 40 mg of elemental iron (pediatric preparations) causes fewer side effects Macrocytic Anemia (MCV > 100 fl) Alcoholism Liver disease Myelodysplastic syndrome Myelophthisis Drugs Megaloblastic anemias Normal variant/ spurious Megolablasts 4 Myelodysplastic Syndrome Normocytic Anemias Normal MCV and RI > or = 3% Bleeding Hemolysis Hemolysis Elevated reticulocyte index ( > or = 3%) Polychromasia Nucleated RBCs Spheroc ...

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