By William F. Kern MD
PDQ Hematology is a concise and centred creation to medical hematology. It succinctly covers crucial facets of the sector with an emphasis on medical gains, prognosis, and remedy. PDQ Hematology completely examines these stipulations usually encountered through physicians and comprises common ideas for more odd or complex ailments. The textual content additionally includes a dialogue of malignant lymphomas in addition to the standard scientific hematology subject matters (such as anemia and leukemia). The large use of tables and diagrams make this moveable publication an available and sensible better half.
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When and what circumstances? A previous normal CBC helps exclude an inherited disorder Previous diagnosis of anemia? Possible recurrence of previous disease When and what circumstances? Possible recurrence of previous disease Iron, folate, or B12 treatment? When and what circumstances? Family history of anemia Possible inherited hemoglobinopathy, thalassemia, membrane defect, or enzyme deficiency Change in bowel habits? Black or tarry stools? Hematochezia? Iron loss due to peptic ulcer disease, colon carcinoma, or other GI tract malignancy; malabsorption in folate or B12 deficiency Diet: meats, dairy products, fresh fruits and vegetables Does the patient have adequate intake of iron (meat), folic acid (fresh fruits and vegetables), and B12 (meat, dairy products)?
Chapter 4 Introduction to Anemia 47 Does the patient have a family history of anemia or ethnic background that may be predisposed to an inherited hemolytic anemia (sickle cell anemia in African Americans; thalassemias in people from Africa, the Mediterranean basin, and the Far East). Some medications may cause oxidative stress in someone with an inherited enzyme deficiency. A morphologic abnormality in the blood smear may suggest a specific cause (sickled cells, spherocytes, “bite” or “blister” cells).
A general approach to the laboratory diagnosis of the anemic patient will be given, based largely on erythrocyte size (MCV). Naturally, the approach for each individual case will be modified by the history, physical examination, and other clinical and laboratory information for that specific patient. Evaluation of a Microcytic Anemia (MCV < 80 fL) The key initial steps in the evaluation of a microcytic anemia are iron indices and examination of a blood smear. The most common cause of microcytic anemia is iron deficiency.
PDQ Hematology by William F. Kern MD