Red blood cells

Red blood cells

1. features

   • • RBCs normal production
       • • a defect in RBC production could lead to
           • anemia
             • anemia is decreased blood mass affecting tissue oxygenation
               • anemia is classified based on morphology and size
                 • • general symptoms
                     • generalized tiredness
                       • history taking in case of generalized tiredness
                         • ask about
                           • Duration Family & dietary history Occupation/Hobbies Prior medical treatment/drugs used Document any blood loss Changes in bowel/urine/body weight Fever Cold intolerance
                         • physical examination
                           • diagnosis
                             • blood test
                               • MCV :Mean corpuscular volume
                                 • the average volume per red cell, expressed in femtoliters (cubic microns)
                               • MCH: mean cell Hemoglobin
                                 • the average mass of hemoglobin per red cell, expressed in picograms.
                               • MCHC: mean cell hemoglobin concentration
                                 • the average concentration of hemoglobin in a given volume of packed red cells,
                               • red cell distribution width
                                 • the coefficient of variation of red cell volume.
                               • hematocrit/packed cell volume/ erythrocyte volume fraction
                                 • is the proportion of blood volume that is occupied by RBCs.
                             • blood film report
                               • microcyte
                                 • RBCs are smaller than normal
                               • hypochromic
                                 • increased zone of central pallor
                               • anisocytosis
                                 • variation in size
                               • poikilocytosis
                                 • variation in shape
                             • these results lead to
                               • iron deficiency anemia
                                 • its the most common nutritional disorder in the world
                                 • causes
                                   • blood loss
                                     • accidant
                                     • menstruation
                                     • peptic ulcers
                                   • inadequate dietary uptake
                                     • vegetarian diet
                                   • impaired absorption
                                   • increased demands
                                     • pregnancy
                                   • signs and symptoms
                                     • koilonychia
                                     • alopecia
                                     • Angular cheilosis
                                     • Glossitis
                                     • management
                                       • oral iron therapy
                                         • given as salt
                                         • taken on empty stomach
                                         • taken with Vit. C
                                       • parenteral iron therapy (IM, IV)
                                         • useful in patients with absorption disorder
                                         • rapid result
                                         • chronic kidney disease
                                       • treating the underlying cause
                                         • heavy menstrual flow
                                         • peptic ulcer
                                         • bleeding tumors
                                 • IDA Vs. Thalassemia
                             • hemoglobin electrophoresis
                           • looking at the patient for an unusual habitus or appearance of underdevelopment, malnutrition, or chronic illness.
                           • pallor, abnormal pigmentation, icterus, spider nevi, petechiae, purpura, angiomas, ulcerations, palmar erythema,
                           • search for hepatomegaly and splenomegaly.
                           • rectal and pelvic examination
                           • systematic examination for palpable enlargement of lymph nodes
                             • it could show evidence of infection or neoplasia.
                     • palpitation
                     • shortness of breath
                     • pallor

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