quick reference
Lab Value Definition:
Hemoglobin (adult): <14 ♂ <12 ♀
Hematocrit: (adult): <42 ♂ <36 ♀
Transfusion Criteria
<8 - normal adults
<7 hospitalized
pathophysiology
etiology
Microcytic
- IDA
- Thalassemias
- Lead/copper
Macrocytic - Hypothyroidism
- Alcohol
- Reticulocytosis (increased avg. size)
- Meds ()
Megaloblastic (w/ hypersegmented PMNs) - B12/Folate deficiency
- Meds that impair DNA synthesis
- methotrexate
- TMP-SMX
- Sulfasalazine
clinical features
Signs
- Pallor
- Conjunctival, Mucosa, then skin
- Nail changes
- Koilonychia (FE deficiency)
- Tachycardia
- Bounding pulse
- Jaundice (hemolytic anemia)
Symptoms
- Fatigue
- Weakness
- Dyspnea
- Dizziness
- Pica – Ice, dirt, clay, starch etc.
- Restless Leg Syndrome
- Pulsatile Tinnitus
diagnosis
Iron Deficiency Anemia
low iron/ferritin, high TIBC, low TSAT
Iron Deficiency without Anemia
Thalassemia
*** look for when degree of microcytosis outstrips the degree of Anemia (Hgb 10, MCV 68)
IDA vs Thal calc: Mentzer Index