Tuesday, March 9, 2010

Iron deficiency anemia

Iron deficiency anemia – Chronic


 

Definition  

A reduction in serum RBC concentration due to inadequate iron stores in the body which results in formation of hypochromic, microcytic erythrocytes


 

Medical History  

* Gastrointestinal hemorrhage, chronic

* Menorrhagia

* Pregnancy

* Malabsorption syndrome

* Iron deficiency anemia secondary to inadequate dietary iron intake


 

Findings  

* Dyspnea - Chronic

* Sinus tachycardia

* Angular cheilitis

* Atrophic condition of skin

* Fatigue

* Headache

* Koilonychia

* Pallor

* Pica

* Telangiectasia

* Splenomegaly


 

Tests  


 

Suspected iron deficiency anemia  

* Complete blood count with white cell differential, manual


 

Screening for iron deficiency anemia  

* Measurement of total hemoglobin concentration: Two Hgb values below the accepted threshold are presumptive for iron-deficiency anemia. The diagnosis can be confirmed if hgb values rise to 1 g/dL or greater after 4 weeks of iron supplementation therapy .


 

Suspected anemia  

* Hematocrit determination: Very mild anemias are associated with few or no clinical signs or symptoms; therefore, a mild anemia usually is first detected from a screening measurement of Hgb or HCT.


 

Anemia  

* Peripheral blood smear examination, light microscopy: Blood smear examination is indicated in the initial evaluation of suspected or unexplained anemia .


 

Suspected or known anemia  

* Reticulocyte count: The reticulocyte count is essential for differentiating between anemias arising from nonfunctional versus functional bone marrow .


 

Suspected iron deficiency anemia  

* Erythrocyte mean corpuscular volume determination: A low mean corpuscular volume (< 80 fL), together with a low RBC count and high red cell distribution width, favors the diagnosis of iron deficiency .


 

Suspected iron deficiency to evaluate presence of hypochromic anemia  

* Mean corpuscular hemoglobin concentration determination


 

Suspected iron deficiency anemia  

* Red cell distribution width determination: An increased red cell distribution width (RDW) is an early hematologic manifestation of iron deficiency anemia .


 

Suspected iron deficiency  

* Serum iron measurement: Low serum iron in the presence of elevated total iron-binding capacity and low serum ferritin is considered diagnostic for iron deficiency .


 

Suspected iron-deficiency anemia  

* Total iron binding capacity measurement: Total iron binding capacity is a useful test in evaluating iron-deficiency anemia, but only in conjunction with other iron studies .


 

Suspected iron deficiency anemia  

* Serum ferritin measurement: A ferritin level of 15 mcg/L or less is a marker of depleted or absent iron stores, and confirms iron deficiency anemia in the presence of low Hgb or HCT


 

Suspected or known iron deficiency  

* Transferrin saturation index: An iron saturation of less than 16% in the presence of an increased transferrin concentration differentiates iron deficiency from inflammation .


 

Suspected gastrointestinal bleeding  

* Screening for occult blood in feces: A positive fecal occult blood test may reflect gastrointestinal bleeding and colonoscopy or upper endoscopy may be indicated .


 

Suspected gastrointestinal bleeding in Henoch-Schönlein purpura  

* Screening for occult blood in feces


 

Unexplained iron deficiency anemia to determine potential locations of blood loss  

* Esophagogastroduodenoscopy

* Colonoscopy


 

Differential Diagnosis  

* Hemorrhage

* Anemia of chronic disease - Chronic

* Anemia of pregnancy

* Thalassemia - Chronic

* Sideroblastic anemia

* Hemolytic anemia

* Aplastic anemia - Acute

* Leukemia

* Megaloblastic anemia

* Myelodysplastic syndrome - Chronic


 

Treatment  


 

Drug Therapy  


 


 

Anemia of pregnancy  


 

FOLIC ACID  

Adults: 400 mcg orally once daily


 


 

Iron deficiency anemia  


 

Ferrous Sulfate  

Adults: 300 to 325 mg orally 3 times daily between meals until ferritin and Hgb are normal


 

Ferrous Gluconate  

Adults: 300 to 325 mg orally 3 times daily between meals until ferritin and Hgb are normal


 

Ferrous Fumarate  

Adults: 300 to 325 mg orally 3 times daily between meals until ferritin and Hgb are normal

2 comments:

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  2. I''m Charlotte Johnson,65  years old, Here in Edmonton, Canada. With the new herbal mix medicine I purchased from Dr James herbal mix medicine West Africa  was my only way to get rid of my Alzheimer's, the herbal  mix medicine effectively reversed my condition and alleviate all symptoms.  I was initially very hesitant to discuss my Alzheimer but I just hope it can still help someone. I feel this will be very important information for all Alzheimer patients, because the most violent element in society today is ignorance. Be it any condition, a healthy diet and natural herbs and roots medicine from Dr. James is the road to fast recovery. I had suffered Alzheimer for many years, I fought for proper medical recommendation, care  and all form of humane treatment with little improvement I went through many sleepless nights and periods of intense grief, as do most families. I was recommended by a friend to use Dr. James herbal mix medicine for my Alzheimer with high hope and assurance. I never doubted my friend but to contact Dr. James. And purchased His herbal mix medicine which was effective and I finally feel my Alzheimer is gone with no more symptoms. He also told me that he cures diseases such as  Lungs diseases, kidney diseases, Warts, Bipolar disorder, Shingles,  HPV, ALS, CANCER, NEPHROTIC SYNDROME, HIV / AIDS, Herpes virus, Ovarian Cancer, Pancreatic cancers, bladder cancer, prostate cancer, Glaucoma., Cataracts, Macular degeneration, Cardiovascular disease, Autism. Enlarged prostate, Osteoporosis. Alzheimer's disease, psoriasis, Tach Diseases, Lupus, Backache, dementia, skin cancer,.testicular Cancer, Leukemia, HEPATITIS A, B, C, Contact  the great one on his email    greatcureman@gmail.com
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SYSTEM BASED CLASSIFICATION OF DISEASES

SYSTEM BASED CLASSIFICATION OF DISEASES

Bone and Joint Diseases

  1. Gout and Hyperurecemia
  2. Osteoarthritis
  3. Rheumatoid Arthritis
  4. Acute coronary Syndroms

Cardiovascular Diseases

  1. Arrhymias
  2. Cardiopulmanary Resuscitation
  3. Heart Failure
  4. Hypertension
  5. Hyperlipidemia
  6. Ischemic Heart Diseases
  7. Shock
  8. Stroke
  9. Venous Thromboembolism

Dermatrologic Diseases

  1. Acne
  2. Psoriasis
  3. Skin Disorders and Cutaneous Drug Eruptions

Endocrine Diseases

  1. Cirrhosis
  2. Portal Hypertension

Gastrointestinal Diseases

  1. Irritable Bowel Syndrome
  2. Constipation
  3. Diarrhea
  4. Gastroesophagal Reflux Disease
  5. Hepatitis, Viral
    1. Hepatitis A
    2. Hepatitis B
    3. Hepatitis C
  6. Nausea and Vomiting
  7. Pancreatitis
  8. Peptic Ulcer disease

Gynecologic and Obstetric Diseases

  1. Contraception
  2. Hormone therapy

Hematologic Diseases

  1. Anemia
    1. Megaloblastic Anemia

i. Megaloblastic Anemia due to Folate Deficiency

ii. Megaloblastic Anemia due to Vitamine B12 Deficiency

    1. Sickle Cell anemia
    2. Hemolytic Anemia
    3. Iron Deficiency Anemia
    4. Aplastic Anemia
    5. Iron Deficiency Anemia

Infectious Diseases

  1. Central Nervous System infections
  2. Endocarditis
  3. Fungal infections, Invasive
  4. Gastrointestinal Infection
  5. HIV / AIDS
  6. Intra-Abdominal Infection
  7. Respiratory Tract infections, Lower
  8. Respiratory Tract infections, Upper
  9. Sepsis and Septic Shock
  10. Sexually transmited Diseases (STD)
  11. Skin and soft tissue infection
  12. Tuberculosis
  13. Urinary tract infection and prostatitis

Neurologic Diseases

  1. Epilepsy
  2. Headache
    1. Migraine
    2. Cluster Headache
  3. Pain management
  4. Parkinson’s Diseases
  5. Status epilepticus

Nutritional Diseases

  1. Enteral Nutrition
  2. Obesity
  3. Parentaral Nutrition

Onchologic Diseases

  1. Breast cancer
  2. Colorectal Cancer
  3. Lung cancer
  4. Lymphomas
  5. Prostate cancer
  6. Cervical Cancer
  7. Esophageal Cancer
  8. Gastric Cancer
  9. Head and Neck Cancer
  10. Lung Cancer
  11. Ovarian Cancer
  12. Pancreatic Cancer
  13. Primary bone Cancer
  14. Primary Brain cancer
  15. Testicular Cancer
  16. Thyroid Gland Cancer
  17. Urinar Bladder cancer
  18. Uterine Cancer

Ophtalmic Diseases

  1. Glaucoma

Psychiatric Diseases

  1. Alzhimer’s Diseases
  2. Anxiety Disease
  3. Bipolar Diseases
  4. Depressive diseases
  5. Schizophrenia
  6. Sleep Diseases
  7. Substance-Related Diseases

Renal Diseases

  1. Acid base Diseases
  2. Acute renal Failure
  3. Chronic Renal Failure
  4. Drug Dosing in renal insufficiency
  5. Electrolyte Homeostasis

Respiratory Diseases

  1. Allergic Rhinitis
  2. Asthma
  3. Chronic Obstructive Pulmonary Diseases

Urologic Diseases

  1. Benign Prostatic, Hyperplasia
  2. Erectile Dysfunction
  3. Urinary Incontinence