Anemia – Diagnosis, Evaluation And Treatment
Question. How will you investigate anemia?
Answer. Every case of anemia should have the following investigations to detect degree and cause of anemia:
- Hemoglobin count decreases.
- RBC count, packed cell volume, mean corpuscular volume and mean corpuscular hemoglobin concentration (MCHC).
- Total leukocyte count and
diffrential leukocyte count. - Peripheral blood fim for type of anemia and shape of RBCs and presence of any abnormal cells.
- Clottng time and bleeding time inhemolytic anemia.
- Blood platelets.
Anemia Diagnosis, Evaluation, and Treatment
Bone marrow examination is done, when cause of anemia requires further investigation, especially to detect type of erythropoiesis.
Anemia Other Investigations
- Stools for parasites: Test for presence of blood and stools is done in patients suspected to chronic blood loss.
- Urine for albumin, bile salt, pigments and urobilinogen
- Gastric analysis: Histamine fast achlorhydria in pernicious anemia and megaloblastic anemia.
- Studies for detecting steatorrhea and malabsorption studies.
- Schilling test for vitamin B12 absorption in megaloblastic and dimorphic anemias.
- F IGLU test is done to assess folic acid defiiency. 15 gram of histidine hydrochloride is given by mouth and the urine in which it is excreted it is collected over next eight hours.
- Normal excretion is 1–17 mg
Anemia Diagnosis and Treatment Options
Question. Discuss causes of bleeding.
Answer.
Anemia Evaluation: Causes, Symptoms, and Tests
- Bleeding can be the result of inability to form a temporary clot or the inability to form a defiitive clot.
- Inability to form a temporary clot results from inadequate platelet count, i.e. thrombocytopenia or abnormal platelet function, i.e. thrombocytopathy.
- Inability to form a definitive clot results from abnormalities in clottng factor.
- Disseminated intravascular coagulation and hemophilia results in bleeding.
- Idiopathic thrombocytopenic purpura
- Aplastic anemia
- Leukemia.
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