Anemia Questions & Answers

Updated: Nov 26, 2019
  • Author: Joseph E Maakaron, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Questions & Answers

Overview

How is anemia defined?

What causes anemia?

Which lab test findings suggest anemia?

What are the most serious complications of anemia?

What is the life cycle of erythrocytes?

What is the physiologic response to anemia?

What are the causes of anemia?

What are the genetic etiologies of anemia?

What are the nutritional etiologies of anemia?

What are the physical etiologies of anemia?

What are the disease etiologies of anemia?

What are the infectious etiologies of anemia?

What are the blood condition etiologies of anemia?

What are the drug and idiosyncratic etiologies of anemia?

What are rare etiologies of anemia?

How often is anemia associated with cardiac disease in the United Kingdom?

What is the prevalence of anemia in the US?

What is the international prevalence of anemia?

How does the prevalence of anemia vary among races and ethnic groups?

How does the prevalence of anemia vary between males and females?

How does the prevalence of anemia vary among age groups?

Which factors affect the prognosis of anemia?

Which patients with anemia have the worst prognosis?

What is the prognosis of anemias caused by thalassemias?

What is the prognosis of aplastic anemia?

What is the prognosis of anemia caused by bone marrow hyperplasia?

What is the prognosis of anemia caused by hemolytic-uremic syndrome?

What education should be given to patients with anemia?

Presentation

What previous lab findings should be included in the history of a patient with suspected anemia?

What family history and household exposures should be included in the history of a patient with suspected anemia?

What genitourinary and GI history should be obtained in patients with suspected anemia?

What dietary history should be obtained in patients with suspected anemia?

Which nutritional deficiencies should be considered in the history of a patient with suspected anemia?

Which history finding suggests an etiology of more than one bone marrow lineage or coagulopathy in anemia?

What does cold intolerance suggest in patients with suspected anemia?

What does dark urine suggest in patients with suspected anemia?

Which symptoms should be explored when obtaining a history for suspected anemia?

Which skin and mucous membranes exam findings are helpful in determining the etiology of anemia?

What should be the focus of an ocular exam in suspected anemia?

How should an exam be performed in patient with anemia?

What does a finding of hepatomegaly and splenomegaly suggest in a patient with anemia?

What is the role of a rectal and pelvic exam in the evaluation of suspected anemia?

What should a neurologic exam include in patients with suspected anemia?

DDX

Which anemia symptoms are not caused by diminished red blood count (RBC) mass?

What are the differential diagnoses for Anemia?

Workup

What is the first step in the diagnosis of anemia?

What are the WHO criteria for a diagnosis of anemia in children and adults?

What are the Hb level thresholds for an anemia diagnosis in the US?

How is the etiology of anemia determined?

What steps should be taken to determine the etiology of anemia?

How are red blood cell (RBC) cellular indices calculated?

Which conditions are associated with microcytic hypochromic anemia and macrocytic anemia, and how are various forms of red blood cells (RBC) characterized in anemia?

Which tests should be performed in the workup of microcytic hypochromic anemia?

How are iron deficiency and non–transfusion-dependent thalassemia differentiated with lab tests?

Which tests should be performed in the workup of macrocytic anemia?

What are the possible etiologies of normocytic normochromic anemia?

How reliable are hematocrit (Hct) levels to determine blood loss in patient with significant hemorrhage?

Which peripheral smear findings suggest anemia after a significant hemorrhage?

What is the role of serum ferritin testing in the workup of anemia after a significant hemorrhage?

In what circumstances might a hemorrhage be undetected or unreported by a patient?

What are the signs of menstrual bleeding as the etiology of anemia?

What are signs of GI bleeding as the etiology of anemia?

What methods used to detect small daily losses of blood from the gut in patients with anemia?

What is the usual cause of iron deficiency anemia in the US?

Which conditions are associated with microcytic hypochromic anemia?

Which findings suggest hemolysis in patients with anemia?

What testing is done to detect hemolysis prior to the presence of anemia?

What is the role of reticulocyte count in the workup of anemia?

How are hemolytic anemias classified?

What testing should be performed in the workup of hereditary hemolytic anemias?

How are hereditary hemolytic anemias diagnosed?

What is the role of abnormal erythrocyte morphology in the workup of hereditary hemolytic anemias?

What are the most common hereditary hemolytic anemias due to erythrocyte enzyme deficiencies?

What are the possible causes of acquired hemolytic anemias?

How are acquired hemolytic anemias differentiated from hereditary hemolytic anemias?

How are acquired hemolytic anemias diagnosed?

How prevalent is iron deficiency anemia in the US?

How is paroxysmal nocturnal hemoglobinuria diagnosed in patients with anemia?

When are major challenges in the diagnosis of hemolytic anemias?

What is the role of a donor cell chromium survival study in the diagnosis of hemolytic anemia?

What findings suggest a diminished production of red blood cell (RBC) etiology of anemia?

When is bone marrow biopsy indicated in the workup of anemia?

How is the prognosis of aplastic anemia improved by identification of etiologic factors?

What does the presence of myeloid metaplasia suggest in the workup of anemia?

When are endoscopy and radiographic studies indicated in the workup of anemia?

What is the role bone marrow aspirates in the workup of anemia?

What is the role of imaging studies in the workup of anemia?

Treatment

What is the purpose of establishing the etiology of anemia?

What are the treatment options for hereditary hemolytic anemia?

What are the treatment approach considerations for anemia?

When is surgery indicated in the treatment of anemia?

What are the treatment options for beta-thalassemia major and the major hemoglobinopathies?

When is specialist consultation indicated in the management of anemia?

When is inpatient care indicated for the treatment of anemia?

When is blood transfusion indicated in the treatment of anemia?

What are the potential adverse effects of blood transfusion for the treatment of anemia?

What are the treatment options for anemia due to blood loss?

What is the dosage regimen of iron supplements for the treatment of anemia?

What are the treatment options for adults with iron deficiency anemia who cannot tolerate oral iron?

When is nutritional therapy indicated for the treatment of anemia?

Where is iron deficiency anemia most common?

How is aplastic anemia treated?

What are the BCSH treatment guidelines for aplastic anemia?

What is the role of splenectomy in the treatment of aplastic anemia?

When is splenectomy indicated in the treatment of anemia?

What is the indication for bone marrow and stem cell transplantation in the treatment of anemia?

What activity modifications are needed during the treatment of anemia?

What is march hemoglobinuria?

When is transfer indicated for the treatment of anemia?

Medications

What are the therapeutic approaches to anemia and what is the goal of treatment?

How is the appropriate therapy selected for the treatment of anemia?

Which medications in the drug class Glucocorticoids are used in the treatment of Anemia?

Which medications in the drug class Histamine (H2) Antagonists are used in the treatment of Anemia?

Which medications in the drug class Vasopressors are used in the treatment of Anemia?

Which medications in the drug class Electrolyte Supplements are used in the treatment of Anemia?

Which medications in the drug class Vitamins are used in the treatment of Anemia?

Which medications in the drug class Iron Products are used in the treatment of Anemia?

Which medications in the drug class Blood and Blood Products are used in the treatment of Anemia?