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CLINICAL PRESENTATION
OF ANEMIA
Acute anemia is due to blood loss or
hemolysis
Blood lost: hypovolemia dominates
hematocrit and hemoglobin levels do not
reflect
the volume of blood lost.
mild: enhanced O2 delivery is achieved through
changes in the
O2hemoglobin dissociation
curve mediated by a
decreased pH or
increased CO2 (Bohr effect).
1015% : hypotension and
decreased organ
perfusion
>30%
: postural hypotension and tachycardia
Nutritional history
Family history
Geographic backgrounds and ethnic
origins
Clues to the mechanisms of anemia may
be provided on physical examination
infection, blood in the stool,
lymphadenopathy, splenomegaly, or
petechiae.
LABORATORY EVALUATION
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RCN 2004
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CLASSIFICATION OF ANEMIA
defects
(ineffective
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Hypoproliferative Anemias
Maturation Disorders
Maturation disorders are divided into:
nuclear maturation defects, associated with
macrocytosis, (vitamin B12 or folic acid deficiency, drug
damage, or myelodysplasia)
cytoplasmic maturation defects, associated with
microcytosis and hypochromia usually from defects in
hemoglobin synthesis (severe iron deficiency or
abnormalities in globin or heme synthesis.)
TREATMENT ANEMIA
the selection of the appropriate treatment is
determined by the documented cause(s) of the anemia
Often, the cause of the anemia is multifactorial
Therapeutic options for the treatment of anemias have
expanded dramatically during the past 30 years. Blood
component therapy, Recombinant EPO, targeted genetic
therapy.
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