HAEM/ONC

ResponseLow Hb
Low Hct (Microchromic)
Low MCV (Microcytic)

Causes: Blood loss (menstrual, GIT), Poor dietary intake
Treatment: PO iron, Iron infusion, Conservative mgmt (consider EPO), Blood transfusion

ResponsePancytopaenia, blasts

ResponsePancytopaenia, NO blasts, NO reticulocytes

ResponseNomocytosis,
Other cell lines normal
CRF on EUC’s

ResponseMacrocytosis
Deficiency of B12/folate levels

ResponseIsolated anaemia, Schistocytes (Schist = “Divided” in greek)
Unconjugated hyperbilirubinaemia
High LDH, Low haptoglobin
(assess for renal complications - EUC, urinalysis ?free Hb)

Ex
Murmurs, signs of IE, splenomegaly

Causes (Made this a bit nicer from LITFL but was in answer)
Intravascular

• Immune - ABO/Rh Incompatibility, IgG mediated (drugs, Antiphospholipid, lymphoma, SLE), Infection (mycoplasma, EBV)
• Non Immune - Mechanical (cardiac valve), Infection (malaria, severe sepsis), Trauma/burns/DIC, liver disease (EtOH, Wilson’s disease), Thrombotic microangiopathy (HUS, TTP, HELP)

Extravascular (eg in spleen)

• Haemoglobinopathies - Sickle cell, Thalassaemia
• Enzyme abnormalities (G6PD (fava bean, dapsone, nitrofuarntoin), hereditary spherocytosis

ResponseLow Hb, normal MCV (May be microcytic if subacute eg: bleeding ulcer)
Marrow responding with raised reticulocyte count