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Anaemia

Anaemia is a state in which the level of Hb in the blood is below the normal range appropriate to age, sex and altitude

Normal Hb - male 13-16 g/dl
                       female 12-14 g/dl

Classification based on morphology


Microcytic - (Small size) - MCV < 78 fi (low)
Normocytic - (Normal size) -MCV 78-98 Fi (normal)
Macrocytic - (Large size) - MCV >100 Fi (high)

Cause

Microcytic 


  • Iron deficiency anaemia
  • Thalassemia
  • Anaemia lead poisoning
Normocytic

  • Acute blood lose
  • Anaemia of chronic illness
  • Hemolysis
  • Chronic renal failure
Macrocytic

  • Vit B12 or folic acid deficiency
  • Liver disease
  • Alcohol
  • Hypothyroidism
Clinical features

Symptoms


  • Lethargy
  • Weakness
  • Dyspnea on exertion
  • Angina
  • Palpitation
  • Headache
  • Anorexia
  Signs

  • Pallor
  • Tachycardia
  • Wide pulse pressure
  • Elevated JVP
  • Cardiomegaly

Management

  • Secure Airway, Breathing, Circulation
  • O2 if hypoxia
  • Large bore iv cannula 18g/16g
  • Fluid therapy
  • Iron replacement
  • If Hb <7g/dl -Blood transfusion (in cardiac patient Hb <10g/dl)
  • Rule out the cause and Treat