Anaemia

The most common cause of anaemia is iron deficiency anaemia .female in child bearing age (Menses and pregnancy). It is usually hypo chromic microcytic anaemia. Also look for a cause Vitamin B12 associated with neurological damage.

Anaemia

Anaemia

 Anemia Workup
Iron/TIBC/Ferritin Folate/B12 LDH/Bilirubin Haptoglobin/Urine for hemosiderin Coombs Test Direct & indirect Hemoglobin electrophoresis Acid hemolysis Osmotic fragility Rx iron/folate/B12 Type & Cross Transfuse 2-4 units GI Consult Hematology Consult Bone Marrow

Reticulocyte Count - Absolute Value = Retic % x RBC Count eg 0.01 x 5x1012/l = 5x 1010/l Normal up to 1.2x1011/l (120,000/l) More accurate way to assess bodys response to anemia

Mean Corpuscular Volume MCV Macrocytic >100 fl Normocytic 80-100 fl Microcytic < 80 fl

Haemolytic anaemia
Normal survival for RBC IS 100-120 days. On a blood smear one Reticulocyte per 100RBC = 50,000 reticulocyte/UL.

 Physical findings Jaundice Splenomegaly Ankle ulcers

Lab. findings
Reticulocytes count Indirect bilirubin but remember Gilbert disease. No bilirubinuria Peripheral blood smears LDH Haptoglobin Coombs test Haemosidrinuria

Tests Used to Diagnose Hemolysis Reticulocyte count (combined with serial Hb) Haptoglobin Urine hemosiderin Also helpful: Serum bilirubin Serum LDH Hemoglobinuria

 FINDINGS Consistent with Hemolysis (problems with sensitivity and specificity; none define cause) Reticulocyte count Increased Cr51-RBC lifespan Decreased Urine urobilinogen Increased Urine hemosiderin Present Urine hemoglobin Present Serum haptoglobin Decreased Serum LDH (and LDH1:LDH2) Increased Serum unconjugated bilirubin Increased

Tests to define the cause of hemolysis Hemoglobin electrophoresis Hemoglobin A2 (beta-thalassemia trait) RBC enzymes (G6PD, PK, etc) Direct & indirect antiglobulin tests (immune) Cold agglutinins Osmotic fragility (spherocytosis) Acid hemolysis test (PNH) Clotting profile (DIC) NB: These tests do not demonstrate the presence of

This is a form of Glossitis that arises due to a deficiency of Folic Acid or Vitamin B12 in the body. The condition is also known by many other names like Bald Tongue, Atrophic Glossitis and Smooth Tongue. Atrophic Glossitis causes a change in taste sensations as well as pain, tenderness and burning sensation in the tongue.