The Pathophysiologic Process of Anemia Essay.
DISCUSSION WEEK 6
You are seeing a patient with fatigue, pallor, dyspnea on exertion, and palpitations.
The patient is 50 years old. Laboratory report indicates a low hematocrit 32, hemoglobin 9.7 and reticulocyte count low at .47% MCV of 78 and MCHC of 32.1.The Pathophysiologic Process of Anemia Essay.
Describe the pathophysiologic process of Anemia.
Identify two differential diagnoses and provide the pathophysiology of these two differential diagnoses.
Identify the additional workup that is needed to rule in or rule out these differential diagnoses.The Pathophysiologic Process of Anemia Essay.
What clinical signs/symptoms would you expect to see with these two differential diagnoses?The Pathophysiologic Process of Anemia Essay.
What diagnosis do you believe to be correct for this patient.
Anemia’s physiological effect is known to be a function of the overall hemoglobin level and the interval over which the disease develops. The condition can be categorized into several pathophysiologies. These are; accelerated erythrocyte destruction, erythrocyte loss, and decreased production of erythrocytes. However, some forms of Anemia may develop as a result of more than one pathophysiology, such as reticulocytopenia in alcoholics and gastrointestinal losses. It is knowledge of the different pathophysiologies that guides both diagnosis and treatment strategies. Anemia can further be categorized using other discriminants. A common technique for distinguishing anemias is the size of erythrocytes produced and the amount of intracellular hemoglobin (Donkeret al., 2016).The Pathophysiologic Process of Anemia Essay.
As in the patient, common conditions that result in hypochromic microcytic anemia characterized by low MCV and MCH include iron deficiency and thalassemia. Finally, anemias are also classified on whether they are congenital or acquired. Congenital anemias include thalassemias, enzymopathies, and sickle-cell disease, while acquired ones include Anemia of chronic disease, myelophthisic, hemorrhage, and AIHA. However, in all conditions, it is important to note that the risk associated with Anemia is separate from that associated with the underlying medical conditions. An example is the Anemia that is associated with acute leukemia (Nairzet al., 2016).
In microcytic hypochromic Anemia, the body has low RBC levels that are both paler and smaller than usual. Most anemias include iron deficiency anemia, thalassemia, and SideroblasticAnemia. The most common cause of this form of Anemia is an iron deficiency in an individual’s blood. This may result from various processes, including inadequate iron intake in a person’s diet, an inability to absorb iron due to underlying conditions such as Helicobacter pylori infection or celiac disease, chronic blood loss, and pregnancy.Thalassemia, on the other hand, is congenital, resulting from mutations in the genes required for the production of hemoglobin.SideroblasticAnemia may be inherited or acquired from a condition that impedes the body from absorbing iron (Donkeret al., 2016).The Pathophysiologic Process of Anemia Essay.
The second differential diagnosis is leukemia. Like with most malignancies, the exact etiology is yet to be understood. Disruptions in the proliferation and regulation of the bone marrow’s lymphoid precursor cells cause excessive production of immature “blast” cells as well as a subsequent drop in numbers of platelets, white blood cells, and functional white blood cells (Kikushige, 2020).The Pathophysiologic Process of Anemia Essay.
Additional Workup Needed to Rule In or Rule out These Differential Diagnoses
To rule out leukemia,bone marrow aspiration could be conducted. This involves getting a bone marrow sample using a long needle to get some fluid from the marrow, usually from the pelvic bone. Laboratory examination of said fluid, usually under a microscope, will determine the percentage of abnormal cells in the bone marrow, which may confirm the diagnosis for leukemia (Kikushige, 2020). Furthermore, the sample can be used to carry out stain of bone marrow specimen for iron, which is a definitive test for microcytic hypochromic Anemia (Bergamaschi et al., 2018).The Pathophysiologic Process of Anemia Essay.
Clinical signs/symptoms expected with both differential diagnoses
As with the patient, some symptoms of the above differential diagnoses include fatigue, pallor, dyspnea on exertion. Palpitations may also be experienced in both conditions, but they are rare in leukemia patients. Other symptoms include chest pains and dizziness, or light-headedness.
The Correct Differential Diagnosis
While both of the differential diagnoses described above could explain the patient’s subjective and objective data, including low MCV, the correct differential diagnosis is microcytic hypochromic Anemia. This is because the laboratory results did not show abnormal white blood cell levels.The Pathophysiologic Process of Anemia Essay.