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Haemoglobin - 15±2.5, 14 ±2.5 - g/dl PCV - 0.47 ±0.07, 0.42 ±0.05 - l/l (%)
RBC count - 5.5 ±1, 4.8 ± 1 x1012/l MCHC - Hb/PCV - 30-36 - g/dl
Hb synthesis within RBC
MCH - Hb/RBC - 29.5 ± 2.5 pg/l
Haematocrit, effective RBC volume - better
Average Hb in RBC
MCV - PCV/RBC 85 ± 8 - fl www.indiandentalacademy.com
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â&#x20AC;&#x153;Anemia is decreased red cell mass affecting tissue oxygenationâ&#x20AC;? * Low Hb <13.5 (males), <11.5 (females)
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Decreased Production:
Aplastic, Hypoplastic anemias - drugs Deficiency anemias Iron, B12, Folate etc.
Increased loss/destruction:
Blood loss anemias - parasites, bleeding Hemolytic anemias – Immune, mechanical, drugs & toxins. Congenital disorders – Sickle cell, thalassemia
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Most abundant metal, common deficiency..! Limited absorption and no excretory mech. Recycling of iron – dead cells to new cells 1mg/day 3-6G body 1mg/day
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10% of the 10 to 20 mg of dietary iron is absorbed each day to balance the 1 to 2 mg daily loss.
Iron is absorbed in Jejunum. Stored as Ferritin & Hemosiderin. •Laboratory tests:
Serum iron(1mg/l) Serum iron binding capacity (3mg) Serum ferritin (>20ug) www.indiandentalacademy.com
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Chronic Blood loss – parasites, ulcers, hernia, drugs (NSAID), Carcinoma, colitis, diverticulosis etc. Rarely hematuria. Increased need – Pregnancy, children Malabsorption – gastrectomy, coeliac disease. Poor diet – Contributory but rarely the sole cause.
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Anemia Pallor, Weakness, Lethargy Breathlessness on exertion Palpitations may lead to heart failure - edema IDA: Angular cheilosis, atrophic glossitis, dysphagia, koilonychia, gastric atrophy.
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Vitamin B12/Folic acid deficiency Low DNA – less division – more cell size Megaloblasts, Abnormal – destruction – pan-cytopenia Multi System disease – All organs with increased cell division. Macrocytic anemia, pancytopenia. Pernicious anaemia –
autoimmune, Gastric atrophy, VitB12 def.
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All have Polychromasia (Marrow response) Acute blood loss Hemolytic anemias (+ Jaundice)
Immune
– Auto immune & Allo
immune Mechanical - Valve, DIC Hereditary – Sickle, Thalassemia Infection Clostridia, malaria. www.indiandentalacademy.com
Laboratory evaluation Blood smear – Morphology very important CBC, Bilirubin levels Direct and indirect Coombs test (antibody) Hemoglobin electrophoresis – abnormal Hb. Tests for parasites.
Kidney & Liver function tests important*
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