Anemia (Low Red Blood Cells)
- What it is: When your blood doesn’t have enough red blood cells, which makes you look pale.
- Sizes of Red Blood Cells:
- Microcytic Anemia: Red blood cells are too small (less than 80fL).
- Normocytic Anemia: Red blood cells are normal size (80-100fL).
- Macrocytic Anemia: Red blood cells are too big (more than 100fL).
- Causes of Microcytic Anemia:
- Iron Deficiency Anemia: Not enough iron.
- Signs: Pale, short of breath, tired, spoon-shaped nails in adults.
- Labs: Low iron, low ferritin, high TIBC.
- PICA: Craving non-food items (like dirt or ice).
- Plummer Vinson Syndrome: Trouble swallowing because of a web in the food pipe, plus iron deficiency and anemia.
- Anemia of Chronic Disease: Anemia from long-term sickness.
- Sideroblastic Anemia: Body can’t use iron correctly.
- Clue: If a person has anemia and is an alcoholic, takes isoniazid, or has lead poisoning, and their iron levels are normal or high.
- Thalassemia: Problem with making hemoglobin (part of red blood cells).
- Alpha Thalassemia: Problems with genes on chromosome 16.
- If 4 genes are missing, it’s called Hb Bart and babies don’t live.
- If 3 genes are missing, it’s called Hb H and causes anemia.
- If 1 or 2 genes are missing, it’s mild.
- Beta Thalassemia: Problems with genes on chromosome 11.
- If 2 genes are affected, it’s thalassemia major (more serious).
- Can get too much iron from blood transfusions.
- Kids can have severe anemia, poor appetite, pale skin, and a bulging forehead.
- Alpha Thalassemia: Problems with genes on chromosome 16.
- Iron Deficiency Anemia: Not enough iron.
Other Anemias
- G6PD Deficiency:
- Can be triggered by certain infections, fava beans, or medicines like primaquine.
- Red blood cells change shape and get destroyed easily by the spleen, leading to anemia, yellow skin (jaundice), short breath, and tiredness.
- Sickle Cell Anemia:
- Inherited.
- Red blood cells are shaped like sickles.
- Can cause pain in hands and feet, kidney problems, chest pain.
- Spleen may stop working.
- Parvovirus B19: Can cause a sudden drop in red blood cell making.
- PNH (Paroxysmal Nocturnal Hemoglobinuria):
- Anemia where red blood cells break down.
- Red urine in the early morning.
- Treated with Eculizumab.
Megaloblastic Anemia
- What it is: A type of macrocytic anemia.
- Causes: Not enough Vitamin B12 or Folic Acid.
- Vitamin B12 is absorbed in the ileum.
- Folic acid is absorbed in the jejunum.
Aplastic Anemia
- Bone marrow doesn’t make enough blood cells (pale, infections, bleeding).
- Treatment: Bone marrow transplant.
Leukemia (Blood Cancer)
- Cancer of the bone marrow.
- Too many young (blast) or mature white blood cells.
- Types by Age:
- ALL (Acute Lymphoblastic Leukemia): Common in children (0-20 years).
- Signs: Poor appetite, pale, short of breath, weight loss.
- Bone marrow biopsy shows over 20% blast cells.
- AML (Acute Myeloid Leukemia): Common in adults (21-50 years).
- Bone marrow biopsy shows over 20% blast cells.
- Some types have Auer rods (needle-like shapes in cells).
- CML (Chronic Myeloid Leukemia): Common in adults (51-60 years).
- Signs: Anemia, poor appetite, tired, short of breath, weight loss, enlarged spleen.
- Has a special gene change called Philadelphia chromosome (9:22).
- Treated with Imatinib.
- CLL (Chronic Lymphocytic Leukemia): Common in older adults (over 60 years).
- Smudge cells seen in blood.
- ALL (Acute Lymphoblastic Leukemia): Common in children (0-20 years).
Multiple Myeloma
- Cancer of plasma cells.
- Can cause: high calcium, kidney problems, anemia, bone pain.
- Special proteins called Bence Jones protein in urine.
Lymphoma (Cancer of Lymphatic System)
- Hodgkin Lymphoma: Often starts in one area and spreads.
- Most common type: Nodular sclerosis.
- Non-Hodgkin Lymphoma: Can be more spread out.
- Examples: Follicular lymphoma, Mantle cell lymphoma, Burkitt lymphoma.
- Burkitt lymphoma is linked to EBV virus and a specific gene change (8:14).
Bleeding Problems
- Thrombocytopenia: Not enough platelets (cells that help blood clot).
- Can cause easy bleeding.
- Immune Thrombocytopenia (ITP): Body attacks its own platelets.
- Can happen after vaccination or infection.
- Treated with IVIG, steroids, or spleen removal.
- Thrombotic Thrombocytopenic Purpura (TTP):
- Fever, kidney failure, nerve problems, anemia, low platelets.
- Treated with plasma exchange.
- Von Willebrand Disease: Problem with a protein (VWF) that helps platelets stick and blood clot.
- Hemophilia: Genetic bleeding disorder where blood doesn’t clot well.
- Hemophilia A: Most common (85%), problem with Factor VIII.
- Hemophilia B: Problem with Factor IX.
- Hemophilia C: Problem with Factor XI.