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Haem15 - Anemia conclusions & Polycythemia

Pathology of Anemia conclusions & Polycythemia.

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Haem15 - Anemia conclusions & Polycythemia

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  1. Shashidhar Venkatesh Murthy A/Prof & Head of Pathology College of Medicine & Dentistry ….. foundation of clinical medicine Clinical Pathology: RBC 1.3: Anemia Summary CPC System Topic : Term2 Week1 - Haem 1/2. : Haematology - RBC Disorders. : 1: Anemia Intro 2: IDA, MBA & ACD 3: Acquired HA 4: Congenital HA. 5: Others.

  2. Pathogenetic Classification of Anemia:  Decreased Production:  Nutrient Deficiency.  Iron def (IDA) / Megaloblastic (MBA)  Hemopoietic cell defect:  Anemia of chronic disorders (ACD)  Aplastic anemia (AA).  Dysplastic anemia. Myelodysplastic Syndromes  Increased loss / destruction:  Blood loss anemia – Acute / Chronic - bleeding.  Hemolytic anemia – Congenital / Acquired.  Acquired / External injury.  Immune AIHA (Warm/Cold) Mechanical, Drugs, Parasites  Congenital / Internal RBC defect  Defective Membrane (Spherocytic an)  Defective Hemoglobin (Sickle & Thal.)  Deficient Enzyme (G6PD) Top 6 Anemias: 1. IDA & Megaloblastic 2. ACD & Aplastic An. 3. IHA – Warm & Cold. 2 2 2 •Cell Mem •Hb. •Enzymes

  3. Anemia: Summary Megaloblastic anemia DNA: B12, Folate MCV 110 MCV 90 Hemolytic anemia Immune Mechanical Infection Drugs Defective* Aplastic anemia Dysplastic anemia Iron Deficiency anemia Hb: Iron 4

  4. Pallor Haemolytic An. Introduction  Anemia due to Increased RBC destruction   life span (<120d) - Abnormal forms  Bilirubin  Unconj. Jaundice (N. urine)  Increased RBC production - ↑ Reticulocytes  Acute: Pallor, Jaundice (normal urine)  Chronic: Splenomegaly, pigment gall stones.  Intravascular & Extravascular Hemolysis*. Jaundice Unconj. Jaundice Pigment Gall stones Globins Iron Immune Mech. Infection Bil. Conj Splenomegaly Porphyrin   Bil. Unconj

  5. Normal Megaloblastic Iron Deficiency Hemolytic

  6. Anemia clinical Diagnosis History & Exam: Cong / Acq.? Acute / Chronic? Hemolysis? MCV 80-100 >100 < 80 Microcytic Normocytic Macrocytic Iron studies - Ferritin Measure B12 + folate Normal/high Low Low Normal ACD / Thalassemia IDA Megaloblastic Reticulocyte count ACD / high low Hemolytic anemia or blood loss Aplastic anemia

  7. Sideroblastic anemia: Iron  Group of disorders anemia with sideroblasts  (+ve iron). Suggesting lack of Iron utilization.  Microcytic Hypochromic anemia.(Macrocytic/dimorphic)  Two major types:  Congenital: X-Linked, mitochondial etc.  Acquired : Myelodysplastic Syndrome (MDS) Copper & Vit. B6deficiency. Lead poisoning Alcoholism, Drugs, Idiopathic.  Porphyria:  Excess porphyrin secretion.  Acute abdominal pain  Neuropathy etc. Iron stain: blue

  8. Polycythemia: (high Hb)  Relative or spurious erythrocytosis  Dehydration: Diarrhea, vomiting, diuretics, excess alcohol. etc.  Absolute erythrocytosis (True ):  Secondary: Tissue Hypoxia: Smoking (CO), High altitude, Lung disease. Cardiac shunts, High O2affinity Hb. High Erythropoietin – Paraneoplastic Syndromes, Androgen therapy.  Primary - Polycythemia Rubra vera: Myeloproliferative disorder: Neoplastic proliferation of erythroid cells in bone marrow – old age, hepatosplenomegaly.  Hb, skin flushing & Hepatosplenomegaly 10

  9. You are the stone.. Need help? contact me… 1. Office location: DB39-136 (Townsville) 2. Office Tel: 4781 4566 3. Email: venkatesh.shashidhar@jcu.edu.au 4. Emergency?: 0416933704 Need personal coaching? Email me for an appointment.

  10. Be true to your work, your word, & your friend. -- Henry David Thoreau Integrity is doing the right thing when no one is watching….!

  11. Normal Sickle Thalassemia Minor Thalassemia Major

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