Evaluation of Anemia By Dr. Stephen Szabo. Relevant Lab Parameters Primary Complete Blood Count Complete Blood Count RBC count RBC count MCV MCV Hgb Hgb.

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Slide 1Evaluation of Anemia By Dr. Stephen Szabo Slide 2 Relevant Lab Parameters Primary Complete Blood Count Complete Blood Count RBC count RBC count MCV MCV Hgb Hgb Reticulocyte Count Reticulocyte Count Creatinine Creatinine LDH and Bilirubin LDH and Bilirubin Peripheral Smear Peripheral Smear Secondary Hgb Electrophoresis Direct Antibody Test Serum Protein Electrophoresis Haptoglobin Iron Panel B12 (MMA, Homocystiene) Bone Marrow Biopsy Slide 3 The Reticulocyte Count The reticulocyte is a young red blood cell that contains residual ribosomal RNA The reticulocyte is a young red blood cell that contains residual ribosomal RNA Normal Reticulocyte percent is 0.5 to 1.7% Normal Reticulocyte percent is 0.5 to 1.7% Absolute Reticulocyte number is RBC number*Normal Reticulocyte percent (50,000) Absolute Reticulocyte number is RBC number*Normal Reticulocyte percent (50,000) Absolute Reticulocyte percent Absolute Reticulocyte percent Normal Retic % *(Hct/45) Normal Retic % *(Hct/45) For severe anemia 410 Slide 13 How to Calculate Total Iron Needed Body Weight (kg)x2.3x(15-pts Hgb) + 500 mg Body Weight (kg)x2.3x(15-pts Hgb) + 500 mg Slide 14 Copyright 2002 American Society of Hematology. Copyright restrictions may apply. Maslak, P. ASH Image Bank 2002;2002:100394 Figure 2. Peripheral smear from a splenectomized patient with recurrent autoimmune hemolytic anemia Slide 15 Copyright 2002 American Society of Hematology. Copyright restrictions may apply. Maslak, P. ASH Image Bank 2002;2002:100394 Figure 1. Circulating nucleated RBC (arrow) in the peripheral smear of a patient with autoimmune hemolytic anemia (MacNeal Tetrachrome 1000x) Slide 16 Copyright 2002 American Society of Hematology. Copyright restrictions may apply. Schrier, S. ASH Image Bank 2002;2002:100344 Figure 5. This patient has hereditary elliptocytosis Slide 17 Copyright 2005 American Society of Hematology. Copyright restrictions may apply. Lazarchick, J. ASH Image Bank 2005;2005:101384 Figure 2. The crystal-like inclusions are more evident at higher magnification of the previous image Slide 18 Copyright 2002 American Society of Hematology. Copyright restrictions may apply. Schrier, S. ASH Image Bank 2002;2002:100344 Figure 7. Peripheral smear of a patient with severe alcoholic liver disease Slide 19 Copyright 2001 American Society of Hematology. Copyright restrictions may apply. Schrier, S. ASH Image Bank 2001;2001:100248 No Caption Found Slide 20 Copyright 2001 American Society of Hematology. Copyright restrictions may apply. Schrier, S. ASH Image Bank 2001;2001:100248 No Caption Found Slide 21 Copyright 2001 American Society of Hematology. Copyright restrictions may apply. Schrier, S. ASH Image Bank 2001;2001:100249 Figure 1. Note the fragmented schistocytes, burr cells, and helmet cells Slide 22 Copyright 2002 American Society of Hematology. Copyright restrictions may apply. Schrier, S. ASH Image Bank 2002;2002:100325 Figure 1. Note the profound central pallor of the hypochromic and microcytic RBC Slide 23 Copyright 2001 American Society of Hematology. Copyright restrictions may apply. Schrier, S. ASH Image Bank 2001;2001:100231 No Caption Found Slide 24 Copyright 2001 American Society of Hematology. Copyright restrictions may apply. Schrier, S. ASH Image Bank 2001;2001:100231 Figure 2. Note the hypersegmented neutrophil (7-8 lobes)

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