Outcome : The student will know :• -The definition of anemia .• -The classification of anemias .• -The diagnosis of anemias

Course title : Hematology (1)Course code :MLHE-201 Supervisor : Prof Dr. Magda Sultan 14/11/2013.

Introduction ToAnaemias

2013

Definition of anaemiaReduction below normal in the concentration of Hb or RBCs ( according to age and sex )

Adult male: Hb 13.5-17.5 g/dl RBCs 4.5 – 6.00 Adult female : Hb 12.0- 16.0 g/dl RBCs 3.80-5.00

The approach to the diagnosis :1-Detection of the anaemia ( by accurate

measurements of the patient values)2-Type of the anaemia .3-Investigations of the cause of anaemia

• Laboratory evaluation of anaemia : 1-Study of the blood :• -Complete blood count ( Hb, Ht, RBCs, Red cell

indices , WBC and platelets )• -Examination of stained blood film .• -Reticulocyte count .

2- Other laboratory tests : -Serum iron ,TIBC, serum ferritin , B12, folate,

Coomb's test , osmotic fragility , G6PD ,Hb electophoresis ,ESR , liver and kidney functions tests , thyroid tests ,bone marrow examination.

• Classification of anaemias Morphologic classification :

Blood film + Red cell indices

• 1-Microcytic Hypochromic anaemia : MCV reduced and MCH reduced • 2-Normocytic Normochromic anaemia : MCV normal and MCH normal • 3-Macrocytic anaemia : MCV increased

• Microcytic Hypochromic anaemia Causes : 1-Iron deficiency anaemia . 2-Thalathemias. 3-Haemoglobinopathies. 4-Chronic disorders .

• Investigations : 1-Serum iron . 2-TIBC . 3-Serum ferritin . 4-Haemoglobin electrophoresis .

• Nomocytic Normochromic anaemia Causes : 1-Haemolytic anaemia . 2-Post haemorrhagic anaemia . 3-Liver disease . 4- Renal disease . 5-Endocrine disorders . 6-Hypoplastic anaemia . 7-Bone marrow infiltration .

• Investigations : 1-Reticulocyte count . 2-Coomb's test .3-Hb electrophoresis . 4-Osmotic fragility .5-G6PD 6- Endocrine tests 7-Liver and renal function tests.8-Bone marrow aspiration and biopsy

• Macrocytic anaemia Types : • 1-Megaloblastic 2- Non Megaloblastic Causes :1-Vitamin B12 deficiency . 2-Folate deficiency .3-Haemolytic anaemia . 4-Haemorrhage .5-Alcohol . 6-Liver and thyroid diseases.7-Hypoplastic bone marrow.

• Investigations : 1-Serum B12

2-Folate assay 3-Bone marrow examination 4-Reticulocyte count 5-Tests for liver and thyroid disorders .

• Assignement : Student name : Title : Microcytic hypochromic anaemia . Student name : Title:Normocytic normochromic anaemia

Assignment Student Name Topic

ابراهيم ابراهيم محمدفتوح احمد محمدمحمد احمد محمد

الغني عبد انور محمداسماعيل خالد محمد

السيد صالح محمدجامع الدين صالح محمد

ابراهيم خضر عادل محمد

Microcytic hypochromic anaemia

النقيب رمضان علي محمدفوده محمد هشام محمد

حسن حمدي محمدمحمود محمد الله هبه

ابراهيم المنعم عبد زينبلطفي احمد

احمد محمود نديعامر سعد سعد احمد محمود

Normocytic normochromic anaemia

• Training Questions : -Define anaemia . -Mention the morphologic classifications of

anaemias. • Reference book : -Essential haematology -Dacie