Athenia feels tired

Athenia feels tired

1. Anemia

   • Reduction in red cell mass resulting in reduced oxygen carrying capacity of blood
   • Can be detected by RBC measurements :
     • Hemoglobin (gm/dL)
     • Hematocrit (%)
     • Red Cell Count
     • Reticulocyte count (%)
   • Classification according to
     • Cause
       • Acute / Chronic Blood loss
         • Hemolytic ( Increased Destruction )
           • Hypoproliferative (Decreased erythropoiesis)
             • Reticulocytes < 3%
           • Reticulocytes > 3%
     • Size based on MCV
       • Microcytic MCV < 80 fl
         • Iron Deficiency Anemia Anemia of chronic disease Sideroblastic anemia Thalassaemia
       • Normocytic MCV 80-100 fl
         • Many Haemolytic Anemias After acute blood loss Renal disease and BM failure
       • Macrocytic MCV > 100 fl
         • Megaloblastic anemia
           • Non-megaloblastic anemia
             • Aplastic anemia , Alcohol Liver disease
           • Vitamin B12 , folate deficiency

2. Erythropoiesis

   • Production of Mature RBCs
     • Hemoglobin
       • 4 Heme groups
         • 1 Iron for each heme
           • Deficiency may lead to :
             • Iron deficiency anemia
               • caused by deficiency of iron needed to produce Hb due to :
                 • Blood loss ( Menstruation/ chronic diseases ) Dietary insufficiencies or iron Malabsorption Increased demands (Pregnancy/ Lactation)
                   • More at risk are:
                     • Women (Child bearing age), Infants and children ,Vegetarians, Frequent blood donors
                   • Signs & Symptoms
                     • General fatigue. weakness. pale skin, shortness of breath, dizziness, Pica, tongue swelling or soreness (Atrophy glossitis) & Angular stomatitis
                   • Diagnosis
                     • History taking
                       • Lab tests
                         • RBC Indices
                           • MCV, MCH, MCHC, RDW
                             • Low MCV
                         • Iron studies
                           • Low Serum iron, Low iron saturation, low ferritin, high TIBC
                       • Family History of Anemia, Splenomegaly,Splenectomy, Exercise intolerance, easy fatigue, Blood loss or bleeding tendency, Chronic disease, Malnutrition, Malabsorption, Transfusion or iron Therapy, Multiple pregnancy menorrhagia
                   • Complications
                     • Strokes, heart failure, tachycardia, koilonychia, coronary insufficiency, cold intolerance, growth impairment, iron overload (transfusions).
                   • Treatment
                     • oral or parenteral iron preparations (ferrous sulfate)
                       • On empty stomach, with Vit C, not with antacids.
         • 1 Porphyrin ring for each heme
           • Heme Synthesis
       • 4 Globin chains
     • Transporters of oxygen through:
     • Morphology :
       • Biconcave, Disc-shaped, anuclear approximately 7-8 microns in diameter internal volume of 80-100 femtoliters (fL)

3. Any reduction results in:

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