i always feel tired

i always feel tired

1. anemia

   • reduction of red cell mass
   • claccifcations
     • related to the size
       • microcytic
         • sidroblastic anemia
           • defect in heme synthesis
         • anemia of chronic diseases
           • inhibits release of iron from stores
         • iron deficiency
           • most common anemia
           • treatment of iron deficiency anemia
             • iron supplements
               • oral
               • IV
             • best absorped on empty stomach
       • macrocytic
         • magaloblastic anemia
           • vit B12 or folate deficiency
       • normocytic
         • hemolytic anemia
           • thalassemia
             • reduced globin chain synthesis
           • sickle cell anemia
             • genetic defect leads to abnormal hemoglobin
           • hereditary spherocytosis
             • genetic defect in genes coding for ankyrin and spectrum
       • MCV
     • related to the pathophysiology
       • blood loss
       • hemolytic
       • decreased production

2. risks of becoming a vegetarian

   • increased risk of colorectal cancer
   • lower bone mineral density
   • lower levels of iron and B12

3. hematopoiesis

   • production of blood cells
   • erythropoiesis
     • occurs in the bone marrrow
     • hemoglobin
       • synthesis
         • globin synthesis
         • heme synthesis
           • iron
             • iron transportation
           • protoporphyrin
       • types
         • adult
           • A2 (a2d2)
           • A (a2b2)
         • embryonic
           • (z2e2) Gower 1
           • (z2g2) Portland
           • (a2e2) Gower II
         • fetal
           • a2g2
     • RBC’s Characteristics
       • biconcave
       • disc-shaped
       • anuclear cells
       • 7-8 micrones in diameter
       • internal volume of 80-100 fL
       • live for 120 days

4. history taking

   • family history
   • history of chronic illness
   • gynecological and gastrointestinal history
   • changes in body weight
   • bowel movement
   • diet
   • drugs
   • environmental exposures
     • lead poising

5. investigations

   • complete blood count
     • iron studies
       • TIBC
         • amount of iron available to be occupired
       • % saturation
         • amount of trensferrin occuped by iron
       • serum iron
         • amount of iron in plasma
       • serum ferritin
         • amount of iron in the stores
     • RBC incides
       • MCV
       • RDW
       • PCV
   • electrophoresis
     • is the movement of molecules by an electric current.
   • blood feilm
     • assessing
       • morphology of WBC's
       • morphology of platelets
       • morphology of RBC's
         • size
         • shape
           • poikilocytosis
         • color
           • hypochromia
           • hyperchromia
           • polychromia
           • anisochromia

6. physical examination

   • inspection
     • arms
       • scratch marks
       • ecchymosis
     • hands
       • kolionchia
     • eyes
       • pallor
       • jaundice
     • mouth
       • angular stomatitis
       • atrophic glossitis

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