week 9 task[norms: RBCs 4-6 mill Hct 42-52% MCV 80-95] Though there are several ways to categorize anemias we will focus on cell SIZE. How to label anemias based on cell size & significance of each: 1. On the CBC look at the RBC count: if it is < 4mill the person has anemia. The common S&S of almost any kind of anemia = SOB fatigue weakness. 2. Next look at the MCV: if it is <80 the person has microcytic anemia; if it is 80 to 95 the person has normocytic anemia; if it is >95 the person has macrocytic anemia. Examples of each: 1. Microcytic: slow blood loss like heavy menses or occult GI bleeding; think of losing iron thus making the hemoglobin molecules smaller—thus small RBCs; the fix—give iron & stop the bleeding. 2. Macrocytic: less numbers of RBCs because of a glitch in their proper development; best example is pernicious anemia in which the parietal cells of stomach aren’t putting out enough of the hormone intrinsic factor (can occur in older folks and/or people with chronic GI problems); without IF less B12 is absorbed with less B12 the DNA that codes for proper development of RBCs won’t code properly; result: less numbers of RBCs and they are abnormally large & have diminished function; people with pernicious anemia have the usual anemia S&S plus paresthesias & glossitis; the fix—B12 shots. 3. Normocytic: best example is chronic dz like kidney failure where not enough erythropoietin (EPT) is made (EPT is made by the kidneys) or in certain cancers where RBCs are crowded out by the cancer; the RBC neither becomes smaller or larger—it is the normal size just not many of them.

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