Anemia

ANEMIA ,[object Object],[object Object],www.freelivedoctor.com

Blood Reference Values WBC 4,800-10,800/mm 3 RBC M: 4.7-6.1 mil/mm 3 F: 4.2-5.4 mil/mm 3 ( or x 10 6 /  L) Plt 130,000-400,000/mm 3 Hgb M: 14.0-18.0 g/dL F: 12.0-16.0 g/dL Hct M: 42-52% F: 37-47% MCV [= Hct(%) / RBC count(x10 6 /  L)/10] 80-100  3 (or fL) MCH [= Hgb(g/dL) / RBC count(x10 6 /  L)/10] 27-33 pg MCHC [= Hgb(g/dL) / Hct(%)/100] 32-36 g/dL RDW 8.5-11.5 % reticulocyte (absolute number) 40,000-100,000 /  L www.freelivedoctor.com

Erythrocyte Indices ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

RBC “rule of 3’s” ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

classification of anemia by color ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

anemia ,[object Object],[object Object],www.freelivedoctor.com

ANEMIA morphologic classification microcytic MCV <80 normocytic MCV 80-100 macrocytic MCV >100 www.freelivedoctor.com

ANEMIA classification by volume ,[object Object],[object Object],[object Object],www.freelivedoctor.com

ANEMIA classification by volume ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

ANEMIA classification by volume ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

ANEMIA classification by volume ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

ANEMIA pathophysiologic classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

ANEMIA pathophysiologic classification ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

ANEMIA pathophysiologic classification ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

ANEMIA pathophysiologic classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

ANEMIA pathophysiologic classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],hereditary spherocytosis hereditary elliptocytosis www.freelivedoctor.com

ANEMIA pathophysiologic classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

ANEMIA pathophysiologic classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],pyruvate kinase def. G6PD def. www.freelivedoctor.com

ANEMIA pathophysiologic classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Thalassemia sickle cell disease Hb C disease www.freelivedoctor.com

ANEMIA pathophysiologic classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

ANEMIA pathophysiologic classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],PNH www.freelivedoctor.com

ANEMIA pathophysiologic classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

ANEMIA pathophysiologic classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

ANEMIA pathophysiologic classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Hereditary Spherocytosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Hereditary Spherocytosis www.freelivedoctor.com

Hereditary Spherocytosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Hereditary Elliptocytosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Embden-Meyerhof glycolytic pathway www.freelivedoctor.com

Pyruvate Kinase Deficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

fluorescent spot test ,[object Object],www.freelivedoctor.com phosphoenol pyruvate pyruvate lactate PK ADP ATP *NADH NAD

G6PD Deficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

G6PD Deficiency bite cell Heinz bodies www.freelivedoctor.com

hemoglobin molecule two  chains two  chains four  -globin genes two  -globin genes www.freelivedoctor.com

globin genes www.freelivedoctor.com CH16 CH11

Thalassemia Syndromes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Thalassemia Syndromes pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Thalassemia Syndromes pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

α -thalassemia  1  2  /  normal  1  2  /   + -thal heterozygote (mild)  1  2  /   0 -thal heterozygote (moderate) www.freelivedoctor.com

α -thalassemia  1  2  /   + -thal homozygote (moderate)  1  2  /   0 -thal x  + -thal (severe)  1  2  /   0 -thal homozygote (lethal) www.freelivedoctor.com

β -thalassemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

β -thalassemia promoter gene mutation: 75-80% reduction of transcription rate (  + thal) chain termination mutation: premature termination of mRNA translation (  0 thal) splicing mutation: aberrant splicing (  0 &  + thal) most common cause of thal www.freelivedoctor.com

“ Thalassemia Major” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

“ Thalassemia Major” www.freelivedoctor.com

“ Thalassemia Major” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

“ Thalassemia Minor” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Sickle Cell Disease ,[object Object],[object Object],www.freelivedoctor.com

Sickle Cell Disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Sickle Cell Trait ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Paroxysmal Nocturnal Hemoglobinuria (PNH) ,[object Object],GPI-linked complement reg. Proteins CD55 (DAF) CD59 CD8 binding protein www.freelivedoctor.com

Paroxysmal Nocturnal Hemoglobinuria (PNH) ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

TTP / HUS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

TTP / HUS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Disseminated Intravascular Coagulation (DIC) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Disseminated Intravascular Coagulation (DIC) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Lead Poisoning ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Malaria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Immunohemolytic Anemia ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Immunohemolytic Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Immunohemolytic Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Immunohemolytic Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Drug-Mediated Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Aplastic Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Aplastic Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Megaloblastic Anemia ,[object Object],[object Object],www.freelivedoctor.com

Vitamin B12 / Folate Deficiency ,[object Object],Methylcobalamin a coenzyme for tetrahydrofolate (FH 4 ) www.freelivedoctor.com

Vitamin B12 Absorption Vit B12: absorbed in ileum (with intrinsic factor) Intrinsic factor www.freelivedoctor.com

Vitamin B12 / Folate Deficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Vitamin B12 Deficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Vitamin B12 Deficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Vitamin B12 Deficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

folate deficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

folate deficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Iron Deficiency Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Iron Deficiency Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Iron Deficiency Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Iron Deficiency Anemia ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

sideroblastic anemia ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Sideroblastic Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Sideroblastic Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Sideroblastic Anemia www.freelivedoctor.com

Sideroblastic Anemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

anemia work-up ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

anemia work-up ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Anemia

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Anemia