Hemoglobin

o Males: 12-16 mg/dL

o Females: 11-15 mg/dL
o Best when looking for anemia
Hematocrit:
o 40-45% solid matter the rest constitutes plasma
o If it goes lower than that, you carry less oxygen
o If it goes higher than that, blood gets more viscous and flows poorly
o Used in screening settings
RBC count
o 3-5*106 mcL
If someone is anemic, they may present with low hemoglobin
MCV average size of the RBCs 80-100
o Microcytic teeny tiny bab-beh cells (baby cells)
Larger blood loss lose a bunch of blood and bone marrow will
try to kick more tiny immature baby cells out to make up for the
blood loss
Hemolysis bursting of RBCs
Can be caused by some drugs
o Normocytic normally sized cells
Can occur from variety of causes but mainly there is a loss
somewhere and there is a failure to make it up
Like slow blood loss
o Macrocytic beeg cells (big cells)
Typically macrocytic anemias are metabolic (missing some
vitamins or nutrients)
Also seen in certain types of antiviral therapies
MCH (mena corpuscular homeglobin)
o Tells you what color the cells are
o 27 31 picograms/cell
o Lightly colored cells will have less hemoglobin and oxygen and iron in them
o Could see
Normal RBC count
Light color
Small size
Look at hemorrhage as a concern
Not getting enough iron
Looks like the blood marrow is trying to compensate for blood loss (slow
o

hemorrhage, but is pushing out immature blood cells)

Could see
Low RBC count
Big cells
Normal Hgb
Big cells are compensating for low count of RBCs
Seen a lot in metabolic anemias with antivirals for hep B and HIV (robovirin and
AZT)
Could see

Low Hgb
Normally sized cells
Normally colored
Probably at home and probably from slow blood loss
Is anemia a disease? no, its a finding
o In people over 50 with anemia the biggest concern is to look for
colorectal cancer
One of the most cause of anemia in young adults
o Menstruation
Perimenopausal women
o Abnormal uterine bleeding
Metabolic causes of anemia is uncommon
In oncological conditions
o Anemias are common
Chronic lymphocytic anemia is common in older adults
o CLL usually not fatal
Anemia of chronic disease
o Occurs in many conditions
o But most common in chronic heart disease and chronic lung disease
o Tx iron supplementation
But it is the bricks, but bricks in a pile dont magically form into
a wall
You need EPO (erythropoietin), ferritin, transferrin
These all help to assemble the cells
Iron supplementation makes it harder for people to poop and all
youre doing is stacking up bricks,
In some cases, it may not be the only thing that they need to
look at (need to look at EPO (kidney failure), ferritin, or
transferrin