Problem 1.05 – ANEMIA
Study Guide #4
1. Briefly explain the mechanism behind the various clinical manifestation (signs
and symptoms) of anaemia
Signs
• Pallor- Pallor or paleness may be caused due to the decreased blood supply to the skin. Paleness is related to blood
flow in the skin rather than the deposition of melanin in the skin.
• Tachypnea- it is an increase in breathing rate, during anemia there is buildup of carbon dioxide in the blood which
makes the blood more acidic than usual, alerting the brain. In response, the brain signals the respiratory drive to
increase in pace in an attempt to correct the imbalance. In doing so, the blood pH can return to within the normal
range in acidity.
• Tachycardia- the heart tends to compensate for the lack of red blood cells reaching the body’s tissues by pumping
faster, a condition known as tachycardia.
Symptoms
• Fatigue, lethargy- fatigue happens because your body lacks the iron it needs to make a protein called hemoglobin,
which helps carry oxygen around the body. Without enough hemoglobin, less oxygen reaches your tissues and
muscles, depriving them of energy.
• Dyspnea- is the sensation of breathlessness due to decreased oxygen availability to working muscles.
• Palpitations- are feelings or sensations that your heart is pounding or racing. This is felt due to increased heart rate
(tachycardia) as the heart is working to compensate decreased oxygen supply due to decreased red blood cell in the
body.
• Worsening of symptoms in patients with angina pectoris or claudication, or onset of symptoms with a transient
ischemic attack.
• Gastrointestinal disturbances- anorexia, nausea, bowel irregularity- anorexia is a symptom of anemia as anorexia is
an eating disorder where by individuals are deprived of proper nutrition and results in iron, vitaminB12 and folic acid
deficiency.
2.
List and explain the signs which are specific to various underlying causes of anemia.
Iron Deficiency Anemia
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Koilonychias, brittle nails
Gastric atrophy
Alopecia
fatigue
weakness/ lethargy
pale skin (Pallor)
shortness of breath (dyspnea)
dizziness (vertigo)
strange cravings to eat items that aren’t food, such as dirt, ice, or clay (Pica)
tongue swelling or soreness (Atrophic glossitis)
cold hands and feet
fast or irregular heartbeat (Tachycardia)
brittle nails
Vitamin-deficiency Anemia:
Megaloblastic anemia: Vitamin B12 and/or Folic Acid deficiency
Pernicious anemia: When your body doesn’t absorb enough Vitamin B12
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Fatigue
Shortness of breath
Dizziness (vertigo)
Pale or yellowish skin
Irregular heartbeats
Weight loss
Numbness or tingling in your hands and feet
Muscle weakness
Unsteady movements
Mental confusion or forgetfulness
Hemorrhagic Anemia: Acute and chronic blood loss
 Dizziness (vertigo)
 Fatigue
 Weakness
Hemolytic Anemia
 dark urine
 yellowing of the skin and the whites of the eyes (jaundice)
 heart murmur- whooshing sound
 increased heart rate
 enlarged spleen
 enlarged liver
 paleness of the skin
 fatigue
 fever
 confusion
 lightheadedness
 dizziness (vertigo)
 weakness or inability to do physical activity
Sickle cell anemia
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Periodic episodes of pain, called pain crises, develop when sickle-shaped red blood cells block blood flow through
tiny blood vessels to your chest, abdomen and joints.
Swelling of hands and feet. The swelling is caused by sickle-shaped red blood cells blocking blood flow to the
hands and feet.
Frequent infections. Sickle cells can damage your spleen, hence vulnerability to infections. Sickle cell anemia
vaccinations and antibiotics prevent potentially life-threatening infections, such as pneumonia. Fever can be the
first sign of an infection.
Delayed growth or puberty. Red blood cells provide your body with the oxygen and nutrients needed for growth.
A shortage of healthy red blood cells can slow growth in infants and children and delay puberty in teenagers.
Vision problems. Tiny blood vessels that supply your eyes can become plugged with sickle cells. This can damage
the retina — the portion of the eye that processes visual images — and lead to vision problems.
Pale skin or nail beds.
Yellow tint to the skin or whites of the eyes. (Jaundice)
Aplastic Anemia
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Pallor
Fatigue
SOB
Dizziness
Palpitations
Fever
3. Explain the difference in the clinical presentation of:
 A patient with rapid development of anaemia
Symptoms of anemia caused by sudden red blood cell destruction may include:
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Abdominal pain
Brown or red urine
Jaundice (yellow skin)
Acute blood loss anemia will result in – cold and clammy skin, extreme pallor tachycardia, dyspnea
Symptomatic and can lead to cardiovascular collapse, shock, and death ( mortality)
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 A patient with slowly developing anaemia.
Since the body adjusts to a steady fall in RBC level, symptoms may not be obvious when anemia is mild or
develops slowly.
Fatigue
Dyspnea
Presyncope- light headed
Lethargy, pallor, slow growth and development in children, arrhythmia, dyspnea, decreased ability to
perform physical activity
Briefly describe the irreversible complications of iron deficiency anaemia
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Iron deficiency in infancy (impaired mental and psychomotor development).
altered auditory recognition memory, diminished performance in mental and psychomotor tests at 5 years of
age, alterations in visual attention and concept acquisition.
Neuro-developmental and behavioral disturbances
Decreased motor activity, decreased social interaction, and diminished attention to tasks.
Adolescents who had IDA in infancy continued to score lower than their non-anemic peers in IQ, social
problems, and inattention, even though they received iron treatment.
Heart problems.
Heart has to work harder to move oxygen-rich blood through your body when there are less hemoglobincarrying RBCs. This can lead to several conditions: irregular heartbeats called arrhythmias, a heart murmur,
an enlarged heart, or even heart failure.
Frequent infections
Iron deficiency anemia can affect immune system (the body's natural defense system), making one more
susceptible to illness and infection.
Pregnancy complications
preterm delivery or giving birth to a baby with low birth weight