Detection of anemia

Co-ordinator:Dr.Nitin Raithatha
Represented by:Jay
patel,Alfaz lakhani
Batch:26-50
Clinical
Diagnosis
• History
• Clinical examination
• Hematological
Investigation
• Other Investigation
Clinical symptoms

Easy fatiguability
Palpitation
Shortness of breath
Decrease work or exercise
tolerance
Acute and Chronic
• Acute • Chronic
– Fatiguability – Koilonychia
– Breathlessnes – Angular
s Cheilosis
– Palpitation – Fainting
– Hypotension – Compenseted:
– Tachycardia may have
pulse and BP
normal
History
Age and Parity: Elderly
and multifetal gestation
are more prone

Bruises, Petechial
Hematuria suggest hemmorhage suggest
hemolytic anemia platelet disorder
History
• History of blood loss from bleeding
gums or bleeding piles.
• Family history: Hereditary hemolytic
anemia,bleeding disorder
• Dietry history: with respect to folic
acid intake
• Personal history:
• Menstrual history: Heavy blood loss
• Obstretic history:abortion,Child birth,
Hemmorhage
Pallor
Conjuctival pallor
Koilonychia
Smooth Tongue
Angular Cheilosis
Clinical Examination
• Features of anemia like facial
pallor,pale
conjuctiva,tongue,palmer creases
and nail beds.
• Tongue may have painful ulcers
and necrotic lesions in mouth
• Sternal tenderness near lower or
middle third :acute leukemia
Clinical Examination
• Palpation of liver and spleen and
generalized
lymphedenopathy:chronic infection
and hemolytic anemia.
• Hemic murmurs are common
cardiac signs
• Basal crepitation in lungs suggest
congestive heart failure with severe
anemia.
Laboratory investigation
Hemotological
Investigation
• CBC
– RBC COUNT,Hb
– RBC INDICES
– WBC COUNT
– PLATELET COUNT
– CELL MORPHOLOGY
• Reticulcyte count
• Iron supply studies: Serum
iron,TIBC,s.ferritin
• Marrow examination
Other investigation
• Urine: Hematuria,pus cells,casts
• Urine culture: infection
• LFT
• Stool examination
• Xray chest
• Hemoglobinuria, Hemosiderinuria
• Serum Haptoglobin, S.bilirubin
Iron Deficiency anemia
• Serum ferritin: <12ng/ml:IDA
• Serum iron: <60μg/dl:IDA
• Serum iron binding capacity:
Normal:250-435 μg/dl.
Increased in IDA.
• Serum transferrin receptors,
Free erythropoietin
protoporphyrins, Nestroft test
Interpretation of plasma
Iron
Iron TIBC Ferritin

Iron Decre Increa Decre

deficiency ase se ase
anemia
Anemia of Decre Decre Increa
chronic ase ase se
disease
Pregnancy Increa Increa Norma
se se l
B12 and folate deficiency
• Hypersegmented neutrophils
• Orthochromatic macrocytes
• Howell-Jolly bodies
• Nucleated red cells
• Bone marrow examination:
megaloblastic and aplastic
anemia, Serum VitB12 assay,
Serum folate assay
 Sickle cell anemia
• Sickling test
• PS : sickle cell,
polychromatophil
ia,basophilic
stippling
• Electrophoresis
• Decrease ESR
Aplastic anemia
• CBC and PS: neutropenia,
lymphocytosis,
thrombocytopenia
• Blood test:electrophoresis
• Serum transaminase, bilirubin,
LDH,Coombs test, RFT
• Bone marrow: Hypocellular
with fatty replacement and
plasma cells and mast cell
Thank you

My references: