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Diah Citra Pravitasari

Ayto Septa Firstyandaru
Evita Oktaviani
Faris Maringan S.
Syndi Mayestikaning
Dyas

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Hairullah

Fatmawati

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Hendro Kusdianto
Nining Rahma
Primahayu
Siti Ucik Nurhidayah
Agie De Carlos

ANEMI
ET
A IO
LO

G
Y

EA
TM
EN
T

S
I
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G
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TR

CLINICAL
MANIFESTATIONS

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DIAGNOSIS

The first step in any diagnosis is a physical examination to

determine if the patient has symptoms of anemia and any
complications. Because anemia may be the first symptom of a serious
illness, determining its cause is very important. This may be difficult,
particularly in the elderly, malnourished, or people with chronic
diseases, whose anemia may be caused by one or more factors. A
detailed medical, personal, and dietary history should report:
Any family or personal history of anemia
A history of gallbladder disease, jaundice, or enlarged spleen
Heavy menstrual bleeding in women
Any occurrence of blood in the stool or other signs of internal
bleeding. (Even if the patient has not observed any bleeding,
nonvisible blood may be present, so a rectal exam and stool test are
essential.)
Any dietary history, particularly in people who are elderly, poor, or
both
The doctor should examine the patient carefully, especially checking
for swollen lymph nodes, an enlarged spleen, and pale skin and nail
color.
A complete blood count (CBC) blood test is performed to determine
the presence of anemia. Other iron status blood tests are also used.

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A complete blood count (CBC) is a panel of tests

that measures red blood cells, white blood cells, and
platelets. For diagnosis of anemia, the CBC provides
critical information on the size, volume, and shape of
red blood cells (erythrocytes). CBC results include
measurements of hemoglobin, hematocrit, and mean
corpuscular volume.
Hemoglobin. Hemoglobin is the iron-bearing and
oxygen-carrying component of red blood cells. The
normal value for hemoglobin varies by age and
gender. Anemia is generally considered when
hemoglobin concentrations fall below 11 g/dL for
pregnant women, 12 g/dL for non-pregnant women,
and 13 g/dL for men.
The severity of anemia is categorized by the following
hemoglobin concentration ranges:
Mild anemia is considered when hemoglobin is
between 9.5 - 13.0 g/dL

OMPLETE BLOOD COUNT (CBC)

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OMPLETE BLOOD COUNT (CBC)

Moderate anemia is considered when hemoglobin
is between 8.0 - 9.5 g/dL
Severe anemia is considered for hemoglobin
concentrations below 8.0 g/dL
Hematocrit. Hematocrit is the percentage of blood
composed of red blood cells. People with a high
volume of plasma (the liquid portion of blood) may
be anemic even if their blood count is normal
because the blood cells have become diluted. Like
hemoglobin, a normal hematocrit percentage
depends on age and gender. Anemic ranges for
hematocrit generally fall below:
Children ages 6 months - 5 years: Below 33%
Children ages 5 years - 12 years: Below 35%
Children ages 12 years - 15 years: Below 36%
Adult men: Below 39%

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TREATMENT
Treatment of Anemia Chronic Disease. In general, the best
treatment for anemia of chronic diseases is treating the disease
itself. In some cases, iron deficiency accompanies the condition
and requires iron replacement. Erythropoietin, most often
administered with intravenous iron, is used for some patients.

Oral Iron Supplements

Supplement Forms. There are two forms of
supplemental iron: ferrous and ferric. Ferrous iron is better
absorbed and is the preferred form of iron tablets. Ferrous iron is
available in three forms: ferrous fumarate, ferrous sulfate, and
ferrous gluconate.
The label of an iron supplement contains information
both on the tablet size (which is typically 325 mg) and the
amount of elemental iron contained in the tablet (the amount of
iron that is available for absorption by the body.) When selecting
an iron supplement, it is important to look at the amount of
elemental iron.

A 325 mg iron supplement contains the following

amounts of elemental iron depending on the type of iron:
Ferrous fumarate. 108 mg of elemental iron
Ferrous sulfate. 65 mg of elemental iron

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DOSAGE
Depending on the severity of your anemia, as well as
your age and weight, your doctor will recommend a dosage
of 60 - 200 mg of elemental iron per day. This means taking
one iron pill 2 - 3 time during the day. Make sure your doctor
explains to you how many pills you should take in a day and
when you should take them. Never take a double dose of

iron

Common side effects of iron supplements

include:

Constipation and diarrhea are very common. They are rarely

severe, although iron tablets can aggravate existing
gastrointestinal problems such as ulcers and ulcerative
colitis.
Nausea and vomiting may occur with high doses, but can be
controlled by taking smaller amounts. Switching to ferrous
gluconate
may
help
some
people
with
severe
gastrointestinal problems.
Full recovery takes 6 - 8 weeks. Recovery will take longer in
people with internal bleeding that is not under control. Iron

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Some common forms of anemia are

most easily prevented by eating a healthy
diet and limiting alcohol use. Many types
of anemia can be avoided by seeing a
doctor regularly to check blood tests and
when problems arise. In the elderly,
routine blood work ordered by the doctor,
even if there are no symptoms, may
detect anemia and prompt the doctor to
look for the underlying causes and
consumption of a healthy diet including
iron-containing foods and those with Bcomplex
vitamins
is
essential
to

PREVENTION

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AVOID ANEMIA
Many types of anemia can't be prevented. However, you can
help avoid iron deficiency anemia and vitamin deficiency anemias
by choosing a diet that includes a variety of vitamins and
nutrients, including:
Iron. Iron-rich foods include beef and other meats, beans, lentils,
iron-fortified cereals, dark green leafy vegetables and dried fruit.
Folate. This nutrient, and its synthetic form, folic acid, can be
found in citrus fruits and juices, bananas, dark green leafy
vegetables, legumes and fortified breads, cereals and pasta.
Vitamin B-12. This vitamin is found naturally in meat and dairy
products. It's also added to some cereals and soy products, such
as soy milk.

Vitamin C. Foods containing vitamin C, such as citrus fruits,

melons and berries, help increase iron absorption.

Consider genetic counseling if you have a family history of

anemia
If you have a family history of an inherited anemia, such as sickle
cell anemia, talk to your doctor and possibly a genetic counselor

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ETIOLOGY
There are more than 400 types of anemia, which are
divided into three groups:
Anemia caused by blood loss
Anemia caused by decreased or faulty red blood cell
production
Anemia caused by destruction of red blood cells

Anemia
Loss

Caused

by

Blood

Red blood cells can be lost through bleeding, which can

occur slowly over a long period of time, and can often go
undetected. This kind of chronic bleeding commonly results
from the following:
Gastrointestinal conditions such as ulcers , hemorrhoids ,
gastritis (inflammation of the stomach ), and cancer
Use of nonsteroidal anti-inflammatory drugs (NSAIDS) such
as aspirin or ibuprofen, which can cause ulcers and gastritis

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Anemia Caused by Decreased or

Faulty Red Blood Cell Production

With this type of anemia, the body may produce

too few blood cells or the blood cells may not function
correctly. In either case, anemia can result. Red blood cells
may be faulty or decreased due to abnormal red blood cells
or the a lack of minerals and vitamins needed for red blood
cells to work properly. Conditions associated with these
causes of anemia include the following:
Sickle cell anemia
Iron-deficiency anemia
Vitamin deficiency
Bone marrow and stem cell problems
Other health conditions

SICKLE CELL ANEMIA

is an inherited disorder that affects African-Americans. Red
blood cells become crescent-shaped because of a genetic
defect. They break down rapidly, so oxygen does not get to
the body's organs, causing anemia. The crescent-shaped red
blood cells also get stuck in tiny blood vessels, causing

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CLINICAL MANIFESTATIONS
The clinical signs that prompt an animals owner to
seek a clinician to diagnose and than treat an anemia
include weakness, lack of stamina, pale mucous
membranes, icterus and hemoglobinoria (red urine). The
purpose of laboratory testing is to provide unbiased
evidence that support or refutes a clinical or lentative
diagnosis. Laboratory diagnosis of the cause of anemia
should be based first on laboratory conclussions founded
on test results and interpretation of cel morphology in
blood
smears
and
graphich
from
hematology
instruments. Only after making those conclusions should
clinical signs, age, breed, and other clinical information
be considered and allowed to influence the conclusions
or diagnosis. This permits laboratory results to indicate
new possibilities and avoid premature closure too
early in diagnosis. Additional, more specific testing may
then be needed.

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