Normocytic normochromic anemia . The World Health Organization has defined anemia as a hemoglobin concentration below 7. L (1. 2 g/d. L) in women and below 8. L (1. 3 g/d. L) in men. Peripheral blood smears from a patient with megaloblastic anemia (left) and from a normal subject (right), both at the same magnification. The smear from the patient shows variation in the size and shape of erythrocytes and the presence of macro- ovalocytes. From Goldman and Bennett, 2. Some types of anemia are named for the factors causing them: poor diet (nutritional anemia), excessive blood loss (hemorrhagic anemia), congenital defects of hemoglobin (hypochromic anemia), exposure to industrial poisons, diseases of the bone marrow (aplastic anemia and hypoplastic anemia), or any other disorder that upsets the balance between blood loss through bleeding or destruction of blood cells and production of blood cells. Anemias can also be classified according to the morphologic characteristics of the erythrocytes, such as size (microcytic, macrocytic, and normocytic anemias) and color or hemoglobin concentration (hypochromic anemia). A type called hypochromic microcytic anemia is characterized by very small erythrocytes that have low hemoglobin concentration and hence poor coloration. Data used to identify anemia types include the erythrocyte indices: (1) mean corpuscular volume (MCV), the average erythrocyte volume; (2) mean corpuscular hemoglobin (MCH), the average amount of hemoglobin per erythrocyte; and (3) mean corpuscular hemoglobin concentration (MCHC), the average concentration of hemoglobin in erythrocytes. Mild degrees of anemia often cause only slight and vague symptoms, perhaps nothing more than easy fatigue or a lack of energy. As the condition progresses, more severe symptoms may be experienced, such as shortness of breath, pounding of the heart, and a rapid pulse; these are caused by the inability of anemic blood to supply the body tissues with enough oxygen. Pallor, particularly in the palms of the hands, the fingernails, and the conjunctiva (the lining of the eyelids), may also indicate anemia. Meaning of normocytic normochromic anemia medical term. Some types of anemia are named for the factors causing them: poor diet (nutritional anemia). How Anemia in dogs is diagnosed. The causes of anemia are so variable that each dog must be assessed physically and in person before a. In very advanced cases, swelling of the ankles and other evidence of heart failure may appear. Common Causes of Anemia. Loss of Blood (Hemorrhagic Anemia): If there is massive bleeding from a wound or other lesion, the body may lose enough blood to cause severe and acute anemia, which is often accompanied by shock. Immediate transfusions are generally required to replace the lost blood. Chronic blood loss, such as excessive menstrual flow, or slow loss of blood from an ulcer or cancer of the gastrointestinal tract, may also lead to anemia. These anemias disappear when the cause has been found and corrected. To help the blood replenish itself, the health care provider may prescribe medicines containing iron, which is necessary to build hemoglobin, and foods with high iron content, such as kidney and navy beans, liver, spinach, and whole wheat bread. Dietary Deficiencies and Abnormalities of Red Blood Cell Production (Nutritional Anemia, Aplastic Anemia, and Hypoplastic Anemia): Anemia may develop if the diet does not provide enough iron, protein, vitamin B1. The combination of poor diet and chronic loss of blood makes for particular susceptibility to severe anemia. Anemias associated with folic acid deficiency are very common. Excessive Destruction of Red Blood Cells (hemolytic anemia): Anemia may also develop related to hemolysis due to trauma, chemical agents or medications (toxic hemolytic anemia), infectious disease, isoimmune hemolytic reactions, autoimmune disorders, and the paroxysmal hemoglobinurias. Patient Care. Assessment of patients with some form of anemia will depend to some extent on the specific type of blood dyscrasia presented. In general, these patients do share some common problems requiring special assessment skills and interventions. Anemia can affect many different body systems (see table). Although pallor of the skin is a sign of anemia, it is not the most reliable sign; many other factors can affect complexion and skin color. Jaundice of the skin and sclera can occur as a result of hemolysis and the release of bilirubin into the blood stream, where it eventually finds its way into the skin and mucous membranes. A bluish tint to the skin (cyanosis) can indicate hypoxia due to inadequate numbers of oxygen- bearing erythrocytes. Activity intolerance is a common problem for patients with anemia. Physical activity increases demand for oxygen, but if there are not enough circulating erythrocytes to provide sufficient oxygen, patients become physically weak and unable to engage in normal physical activity without experiencing profound fatigue. This can result in some degree of self- care deficit as the fatigue interferes with the patient's ability to carry on regular or enjoyable activities. AIHA) an acquired disorder characterized by hemolysis due to the production of autoantibodies against one's own red blood cell antigens. Immune complex problems: Ingestion of any of a large number of drugs is followed by immunization and the formation of a soluble drug–anti- drug complex that adsorbs nonspecifically to the erythrocyte surface. ![]() Drug absorption: Drugs bind firmly to erythrocyte membrane proteins, inducing the formation of specific antibodies; the drug most commonly associated with this mechanism is penicillin. Membrane modification: A nonimmunologic mechanism whereby the drug involved is able to modify erythrocytes so that plasma proteins can bind to the membrane. Autoantibody formation: Methyldopa (Aldomet) induces the production of autoantibodies that recognize erythrocyte antigens and are serologically indistinguishable from those seen in patients with warm autoimmune hemolytic anemia. Iron deficiency anemia is the most common nutritional disorder in the United States. It is unresponsive to hematinics or to withdrawal of toxic agents or drugs and may be preleukemic. Homozygous individuals have the full- blown syndrome with accelerated hemolysis, increased blood viscosity and vaso- occlusion, arthralgias, acute attacks of abdominal pain, and ulcerations of the lower limbs; some have periodic attacks of sickle cell crises. The heterozygous condition is called sickle cell trait and is usually asymptomatic. People are considered anemic when their hemoglobin levels are more than two standard deviations below the mean level in their hospital's laboratory. ![]() The diagnosis of anemia is influenced by variables such as the patient's age (neonates are anemic at levels of hemoglobin that would be considered polycythemic in some adults), gender (men have higher hemoglobin levels than women), pregnancy status (hemodilution in pregnancy lowers measured hemoglobin), residential altitude, and ethnic or racial background. If anemia develops slowly, however, there may be no functional impairment even though the hemoglobin is less than 7 g/1. L of blood. Anemia is not a disease but rather a symptom of other illnesses. It is classified on the basis of mean corpuscular volume as microcytic (8. ![]() Normocytic, normochromic anemia. A dog has regenerative anemia. Cobalamin Deficiency Associated With Erythroblastic Anemia. Cobalamin deficiency associated with erythroblastic anemia and. In young, rapidly growing animals on an all-milk diet. Signs of anemia may include a rapid pulse or rapid breathing if blood loss occurs rapidly. The chronically anemic may have pale skin, mucous membranes, or nail beds and fissures at the corners of the mouth. Treatment. Treatment of anemia must be specific for the cause. The prognosis for recovery from anemia is excellent if the underlying cause is treatable. Anemia due to excessive blood loss: For acute blood loss, immediate measures should be taken to stop the bleeding, to restore blood volume by transfusion, and to combat shock. Chronic blood loss usually produces iron- deficiency anemia. Anemia due to excessive blood cell destruction: The specific hemolytic disorder should be treated. ![]() Anemia due to decreased blood cell formation: For deficiency states, replacement therapy is used to combat the specific deficiency, e. B1. 2, folic acid, ascorbic acid. For bone marrow disorders, if anemia is due to a toxic state, removal of the toxic agent may result in spontaneous recovery. Anemia due to renal failure, cancer chemotherapy, HIV, and other chronic diseases: Erythropoietin injections are helpful. Patient care. The patient is evaluated for signs and symptoms, and the results of laboratory studies are reviewed for evidence of inadequate erythropoiesis or premature erythrocyte destruction. Prescribed diagnostic studies are scheduled and carried out. Rest: The patient is evaluated for fatigue; care and activities are planned and regular rest periods are scheduled. Mouth care: The patient's mouth is inspected daily for glossitis, mouth lesions, or ulcers. A variety of disorders are associated with anemia due to decreased red cell production. NORMOCYTIC ANEMIA WITHOUT LEUKOPENIA OR THROMBOCYTOPENIA; Etiology. Hepatocutaneous syndrome: When liver dysfunction affects. ![]() ![]() A sponge stick is recommended for oral care, and alkaline mouthwashes are suggested if mouth ulcers are present. A dental consultation may be required. Diet: The patient is encouraged to eat small portions at frequent intervals. Mouth care is provided before meals. The nurse or a nutritionist provides counseling based on type of anemia. Medications: Health care professionals teach the patient about medication actions, desired effects, adverse reactions, and correct dosing and administration. Patient education: The cause of the anemia and the rationale for prescribed treatment are explained to the patient and family. Teaching should cover the prescribed rest and activity regimen, diet, prevention of infection, including the need for frequent temperature checks, and the continuing need for periodic blood testing and medical evaluation. See: illustration. Treatment. Many patients can be treated effectively with bone marrow transplantation or immunosuppressive drugs. Patient care. The patient and family are educated about the cause and treatment of the illness. Measures to prevent infection are explained, and the importance of adequate rest is emphasized. In the acute phase, prescribed treatment is carried out; side effects of drugs and transfusions are explained, and a restful environment for the patient is ensured. If the patient's platelet count is low (less than 2.
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