LabTech

6/29/1999

Anemia

• Routine screening test is H/H (hemoglobin and hematocrit)—not enough O2 carrying capacity

• Not enough RBC's or not enough hemoglobin in each RBC
• Threshold values HGB<12g/dL HCT<34%
• Typical follow up tests are

2. RBC indices
3. Reticulocyte count
4. Peripheral smear

Common Anemias

1. Microcytic
2. Macrocytic—pernicious anemia—large, immature cells, vit B12 deficiency, lack intrinsic factor—DNA synthesis
3. Normocytic/normochromic anemia—RBC indices is normal and MCH is normal, peripheral blood cell smear is normal—bone marrow failure, failure to make enough, loss of blood, destruction of RBC—nothing basically wrong w/each red cell—look at reticulocyte count (immature RBC—still have parts of a nucleus, 1% of RBCs are of this type, can't be distinguished from normal peripheral blood smear)—bone marrow failure (aplastic anemia), renal failure (erythropoietin—stimulates bone marrow to make RBCs)

• High reticulocyte count—O.K. RBCs
• Means that are losing RBCs

• Hemolysis—destruction of RBCs
• Sickle Cell Anemia—brittle cells, sickle shape, easily destroyed
• Incompatible blood transfusion—antibodies are destroying
• Autoimmune condition
• Thermal injury (high energy for long periods of time)