Sunday, 19 June 2011

Anaemia

 It is defined as the decrease in the circulating red cell mass.The criteria is Hb(hemoglobin) <12gms/dl in women and <14gms/dl in men.. In terms of hematocrit the criteria is <36% in women and <41% in men.
Classification:
        Based on the etiology
                                           1.Due to blood loss
                                                       - acute
                                                       - chronic
                                           2.Due to decreased RBC production
                                           3.Due to increased RBC destruction
Diagnosis:
       Symptoms&Signs:
                  -Fatigue is the most common presentation.
                  -Headache,tinnitus.exercise intolerance,oligomenorrheoa may be present
                  -On examination pallor,tachycardia,hypotension,edema,kilonychia,angular chelosis,glositis may be present.
      Laboratory investigation:
                     -Hb <12gms/dl in women and <14gms/dl in men
                     -Hct<36% in women and <41% in men
                     -Normal range of Mean corpuscular volume(MCV) 80-96 femtolitres(fl);<80fl indicates microcytosis;>96fl indicates macrocytosis
                     -Reticulocyte index(RI) is a measure of the response of the bone marrow.
                              RI=%reticulocyte X (estimated Hct/normal Hct)
nomal value is 1.0 to 2.0 ; <2.0 indicates decreased production; >2 indicates loss of blood or hemolysis.
                    -Peripheral smear for studying number and morphology of blood cells
                    -Bone marrow biopsy is indicated in cases where cause is not clear.

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