Anemia

Clinic A/P, adults, Clinic A/P, Peds, HEMATOLOGY-ONCOLOGY, Hospital A/P, Adults, Hospital A/P, Peds

Definition: Hgb <13.5 in men or  <12.0 in women.
H&P performed. S/sx of anemia assessed.
Initial labs for all pts: CBC w/ diff, reticulocyte count, and peripheral blood smear to help classify the anemia in microcytic (MCV <80), normocytic(MCV 80-100), and macrocytic (MCV > 100), anemia, evaluate bone marrow response, and evaluate RBC morphology.
DDx and causes reviewed.
Anemia Workup Algorithm reviewed.
Mechanisms causing anemia reviewed.
Additional labs based on the individual case.
If ≥ 50 yrs, the last Colonoscopy was on: _____

Treatment
Based on the cause.

 

Pearls

  • Anemia Workup / Diagnostic Tests for Anemia.
  • Hemolytic Anemia Labs Explained Clearly.
  • What is in a Complete Blood Count (CBC)?
  • Great article on Anemia.
  • Neurological disease is a potential complication of vitamin B12 deficiency but not of folate deficiency. Neurologic symptoms can occur in the absence of anemia.
  • A definitive diagnosis of Vit B12 deficiency in pts w/ low levels of Vit B12 that are above the lower limit of normal requires measurement of methylmalonic acid and homocysteine. For Vit B12 deficiency, both homocysteine and methylmalonic acid are increased. For Folate deficiency, there is increased homocysteine and normal methylmalonic acid.
  • A nonfasting serum folate conc < 2 ng/mL is diagnostic of folate deficiency. A folate level > 4 ng/mL rules out folate deficiency.
  • Transfusions.

 

References/Resources

  • Iron Deficiency Anemia: Evaluation and Management. https://www.aafp.org/afp/2013/0115/p98.html
  • Anemia Screening. https://www.ncbi.nlm.nih.gov/books/NBK499905/
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