Anemia Wikipedia. Anemia is a decrease in the total amount of red blood cells RBCs or hemoglobin in the blood,34 or a lowered ability of the blood to carry oxygen. When anemia comes on slowly, the symptoms are often vague and may include feeling tired, weakness, shortness of breath or a poor ability to exercise. Anemia that comes on quickly often has greater symptoms, which may include confusion, feeling like one is going to pass out, loss of consciousness, or increased thirst. Anemia must be significant before a person becomes noticeably pale. Additional symptoms may occur depending on the underlying cause. The three main types of anemia are due to blood loss, decreased red blood cell production, and increased red blood cell breakdown. Causes of blood loss include trauma and gastrointestinal bleeding, among others. Causes of decreased production include iron deficiency, a lack of vitamin B1. Causes of increased breakdown include a number of genetic conditions such as sickle cell anemia, infections like malaria, and certain autoimmune diseases. It can also be classified based on the size of red blood cells and amount of hemoglobin in each cell. If the cells are small, it is microcytic anemia. If they are large, it is macrocytic anemia while if they are normal sized, it is normocytic anemia. Diagnosis in men is based on a hemoglobin of less than 1. L 1. 3 to 1. 4 gd. L, while in women, it must be less than 1. L 1. 2 to 1. 3 gd. L. 16 Further testing is then required to determine the cause. Certain groups of individuals, such as pregnant women, benefit from the use of iron pills for prevention. Dietary supplementation, without determining the specific cause, is not recommended. The use of blood transfusions is typically based on a persons signs and symptoms. In those without symptoms, they are not recommended unless hemoglobin levels are less than 6. L 6 to 8 gd. L. 18 These recommendations may also apply to some people with acute bleeding. Erythropoiesis stimulating medications are only recommended in those with severe anemia. Anemia is the most common blood disorder, affecting about a third of the global population. Iron deficiency anemia affects nearly 1 billion people. In 2. It is more common in women than men,9 during pregnancy, and in children and the elderly. Anemia increases costs of medical care and lowers a persons productivity through a decreased ability to work. The name is derived from Ancient Greek anaimia, meaning lack of blood, from an, not and haima, blood. Signs and symptomsedit. Main symptoms that may appear in anemia1. The hand of a person with severe anemia on the left compared to one without on the rightAnemia goes undetected in many people and symptoms can be minor. The symptoms can be related to an underlying cause or the anemia itself. Most commonly, people with anemia report feelings of weakness or tired, and sometimes poor concentration. They may also report shortness of breath on exertion. In very severe anemia, the body may compensate for the lack of oxygen carrying capability of the blood by increasing cardiac output. Order Of Bridesmaids In Wedding Program on this page. The patient may have symptoms related to this, such as palpitations, angina if pre existing heart disease is present, intermittent claudication of the legs, and symptoms of heart failure. On examination, the signs exhibited may include pallor paleskin, lining mucosa, conjunctiva and nail beds, but this is not a reliable sign. There may be signs of specific causes of anemia, e. In severe anemia, there may be signs of a hyperdynamic circulation tachycardia a fast heart rate, bounding pulse, flow murmurs, and cardiacventricular hypertrophy enlargement. There may be signs of heart failure. Pica, the consumption of non food items such as ice, but also paper, wax, or grass, and even hair or dirt, may be a symptom of iron deficiency, although it occurs often in those who have normal levels of hemoglobin. Chronic anemia may result in behavioral disturbances in children as a direct result of impaired neurological development in infants, and reduced academic performance in children of school age. Restless legs syndrome is more common in those with iron deficiency anemia. Figure shows normal red blood cells flowing freely in a blood vessel. The inset image shows a cross section of a normal red blood cell with normal hemoglobin. The causes of anemia may be classified as impaired red blood cell RBC production, increased RBC destruction hemolytic anemias, blood loss and fluid overload hypervolemia. Several of these may interplay to cause anemia eventually. Indeed, the most common cause of anemia is blood loss, but this usually does not cause any lasting symptoms unless a relatively impaired RBC production develops, in turn most commonly by iron deficiency. See Iron deficiency anemiaImpaired productioneditDisturbance of proliferation and maturation of erythroblasts. Here is a collection of powerpoint lectures covering all chapters from Robbins patholic basis of disease the latest edition. Well organised powerpoint. Philosophy Metaphilosophy Metaphysics Epistemology Ethics Politics Aesthetics Thought Mental Cognition. The immune checkpoint inhibitor ipilimumab is the standardofcare treatment for patients with advanced melanoma. Pembrolizumab inhibits the programmed cell death 1. Robbins Review Pathology Question Book Pdf' title='Robbins Review Pathology Question Book Pdf' />Other mechanisms of impaired RBC production. Increased destructioneditAnemias of increased red blood cell destruction are generally classified as hemolytic anemias. These are generally featuring jaundice and elevated lactate dehydrogenase levels. Blood losseditThe roots of the words anemia and ischemia both refer to the basic idea of lack of blood, but anemia and ischemia are not the same thing in modern medical terminology. The word anemia used alone implies widespreadeffects from blood that either is too scarce e. Robbins Review Pathology Question Book Pdf' title='Robbins Review Pathology Question Book Pdf' />In contrast, the word ischemia refers solely to the lack of blood poor perfusion. Thus ischemia in a body part can cause localized anemic effects within those tissues. Fluid overloadeditFluid overload hypervolemia causes decreased hemoglobin concentration and apparent anemia General causes of hypervolemia include excessive sodium or fluid intake, sodium or water retention and fluid shift into the intravascular space. Intestinal inflammationeditCertain gastrointestinal disorders can cause anemia. The mechanisms involved are multifactorial and not limited to malabsorption but mainly related to chronic intestinal inflammation, which causes dysregulation of hepcidin that leads to decreased access of iron to the circulation. Robbins Review Pathology Question Book Pdf' title='Robbins Review Pathology Question Book Pdf' />DiagnosiseditDefinitionseditThere are a number of definitions of anemia reviews provide comparison and contrast of them. A strict but broad definition is an absolute decrease in red blood cell mass,3. An operational definition is a decrease in whole blood hemoglobin concentration of more than 2 standard deviations below the mean of an age and sex matched reference range. It is difficult to directly measure RBC mass,3. RBCs or the hemoglobin Hb in the blood are often used instead to indirectly estimate the value. Hemotocrit however, is concentration dependent and is therefore not completely accurate. For example, during pregnancy a womans RBC mass is normal but because of an increase in blood volume the hemoglobin and hematocrit are diluted and thus decreased. Another example would be bleeding where the RBC mass would decrease but the concentrations of hemoglobin and hematocrit initially remains normal until fluids shift from other areas of the body to the intravascular space. The anemia is also classified by severity into mild 1. L to normal, moderate 8. L to 1. 10 gL, and severe anemia less than 8.