Anemia: Lesson 1 - Diagnostic Frameworks

A discussion on the definition, symptoms/signs, and diagnostic frameworks (a.k.a. diagnostic schema) for anemia. Both the morphological (i.e. microcytic vs. normocytic vs. macrocytic) and kinetic (i.e. hypoproliferative vs. hyperproliferative) frameworks are covered, including their limitations.

Пікірлер: 54

  • @GiasAhmed-tq8cx
    @GiasAhmed-tq8cx8 күн бұрын

    You are undoubtedly THE BEST TEACHER! Thank you, Dr. Strong. And love the starting piano of your lessons. 🥰

  • @cornelbacauanu1544
    @cornelbacauanu15445 жыл бұрын

    The best explanation so far of the MCV vs Retic index for clinical practice. Thank you for Anemia lectures.

  • @alexandremello6913
    @alexandremello69135 жыл бұрын

    I am a hematologist and it is great to see a series of talks on anemia on your excellent page. Thanks a lot for your effort in putting together all those lessons. I have two observations. First, in the table of causes of anemia separated by MCV, the anemias caused by marrow invasion by hematologic neoplasms are missing (leukemias, lymphomas, myeloma etc). Second, a suggestion: I teach my students that microcytic anemias all have the common pathophysiolgy of reduced hemoglobin production, while macrocytic anemias are generally the result of troubled DNA synthesis. This is something that they will surely use in their practice.

  • @StrongMed

    @StrongMed

    5 жыл бұрын

    Thanks for the comment sir! Yeah, the anemia by MCV table is missing the marrow diseases - an oversight on my part. Regarding the second suggestion, I've seen people teach this as well and it's a cool way to connect physiology to what's seen on the smear, but have wondered about the macrocytic side...do those etiologies all come from issues with DNA synthesis, or just the megaloblastic anemias? (Honestly don't know, and some references I just checked were a little "hand wavey" about it)

  • @nikolaykondratyev3021

    @nikolaykondratyev3021

    3 жыл бұрын

    What is your opinion of the ret index as discussed in this video? Just out of curiosity.

  • @alexandremello6913

    @alexandremello6913

    3 жыл бұрын

    @@nikolaykondratyev3021 I haven't re-watched the video but what I usually teach my students is to get out of the box when considering ordering a RC. Usually, students build the inflexible and wrong conception that a high RC *means* hemolysis. They have to understand that iron, folate or b12 replenishment will result in a high RC if there was a deficient state. They need to understand that correcting anemia with transfusions will normalize the RC as well as the MCV and can mask the right diagnosis. Another important issue is the correct understanding of the difference between an uncorrected versus corrected RC. So basically I see the RC as a very specific test that should only be ordered to discriminate between an intact or impaired ertythropoietic response to hypoxemia. It is not a screening test, and the classification of anemias into hypo or normo or hyperproliferative is not really a meaningful or practical way to do it. Only order it if you are SURE that it will answer your question.

  • @nikolaykondratyev3021

    @nikolaykondratyev3021

    3 жыл бұрын

    @@alexandremello6913 thank you! :)

  • @Kalemalex

    @Kalemalex

    3 жыл бұрын

    @@alexandremello6913 thanks

  • @jackgreen7273
    @jackgreen72734 жыл бұрын

    IiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiT's about Tiiiiiiiiiiiiiiiime!!!. I must have gone through 2 days worth of watching videos on all sorts of classification of anemias: normo macro micro cytic with each one putting diseases in different categories. Then they throw in Production vs Destruction, and reticulocyte counting. Oh yeah, and the megalo non-megalo thing. I wasted sooooo much time trying to figure it all out. Then I watched your video which simply dealt with the pros and cons of the methods, pointing out that using MCV puts certain anemias in more than one category. Hemolytic can be all three MCVs. Now things make sense. Thanks.

  • @howtomedicate
    @howtomedicate5 жыл бұрын

    Really great video! As a student I always struggled with the diagnostic framework of anemia, but here you explained it very clearly. Thanks 👍

  • @mustafamerrick7975

    @mustafamerrick7975

    2 жыл бұрын

    instaBlaster.

  • @menpagnaroat1269
    @menpagnaroat12695 жыл бұрын

    Thank you very much Dr. Eric for responding to my request.

  • @ooocebutcebut1699
    @ooocebutcebut16995 жыл бұрын

    Thank you!! Thank you!! Thank you!!! Thank you!! Thank you!! All of you videos help more than you know!!!!! Again, Gracias!! And by the way, I would sit through hours of your videos in order to grasp the concept. :) :) Cheers!!

  • @mathesondaniel
    @mathesondaniel5 жыл бұрын

    Thought this said "Diagnostic Fireworks" to begin with, so initially disappointed but still very grateful for the great vid

  • @abc-ei3ik
    @abc-ei3ik4 жыл бұрын

    Nothing’s frustrating, grateful for everything. Ty

  • @haemy5495
    @haemy54955 жыл бұрын

    Thanks Dr. Eric 💕🙏🏻🙏🏻

  • @SFL3G
    @SFL3G5 жыл бұрын

    Thank you sir for sharing always great content on your site.

  • @sarahgamaleldean3775
    @sarahgamaleldean37752 жыл бұрын

    Thanks alot ...waiting for more...lwill always follow..go on u r the top

  • @nasreddinekhayati2121
    @nasreddinekhayati21213 жыл бұрын

    Hello Dr Strong ! I was going through this lecture and particularly the classification of Normocytic anemia. Got this idea to create a group of Anemias of chronic disorder (anemia of Chronic Kidney Disease, anemia of chronic inflammation, and anemia of chronic infection like HIV/AIDS, TB..) I think this could help students and practitioners to memorize this part of anemia's classification

  • @sunving
    @sunving4 жыл бұрын

    Thank you Doctor Strong.

  • @kevouyreid4518
    @kevouyreid45182 жыл бұрын

    These anemia lectures provide a structured and systematic approach to diagnose and investigate patients.

  • @suneelsharma1763
    @suneelsharma17634 жыл бұрын

    great videos sir . i love your lectures. plss keep posting . love from India....

  • @nikolaykondratyev3021
    @nikolaykondratyev30213 жыл бұрын

    You have a great teaching voice.

  • @mariamdaod8184
    @mariamdaod81845 ай бұрын

    Well done Dr Eric

  • @wasm5007
    @wasm50073 жыл бұрын

    would you agree that elderly patients may have low Hb but normal MCV because their kidney function is generally low? Would you treat with iron?

  • @mdsaimon4536
    @mdsaimon45364 жыл бұрын

    Thank u Dr.eric

  • @youssefkhial6791
    @youssefkhial67915 жыл бұрын

    thank you

  • @TriKienkienminhtri
    @TriKienkienminhtri5 жыл бұрын

    Thanks

  • @arielol89
    @arielol895 жыл бұрын

    Thanks 🙏🏻

  • @mamunrashid8972
    @mamunrashid89723 жыл бұрын

    Love love love from Sweden 🇸🇪

  • @Drtehminah
    @Drtehminah5 ай бұрын

    Thanks for. the video series.

  • @Natie_Deme
    @Natie_Deme2 жыл бұрын

    Thank you for the explanation... I am anemic. And I am weighing things before having the covid vaccine.

  • @sonalibanerjee5196
    @sonalibanerjee51962 жыл бұрын

    THANK YOU

  • @DrTay-zn5re
    @DrTay-zn5re5 жыл бұрын

    awesome

  • @chanellewilson7094
    @chanellewilson70945 жыл бұрын

    This is great!! Can you a video on renal disease and interpreting lab work? I work with a huge elderly population and a lot of CKD. As a new NP, it would be a great help.

  • @StrongMed

    @StrongMed

    5 жыл бұрын

    I have a brief series on interpretting the UA which touches on various forms of renal disease: kzread.info/dash/bejne/qomEktaDgNCahpc.html Also a series on AKI: kzread.info/dash/bejne/pHuitLeKqrapp6w.html And there are a number of videos on the main channel about all of the major electrolyte disorders. I don't have any videos specifically on CKD yet, but it's on my list of topics to cover!

  • @nystagmus
    @nystagmus Жыл бұрын

    Just use both retic index and mcv

  • @sorrelknott3653
    @sorrelknott3653 Жыл бұрын

    High MCV but low MCHC - could this mean both Iron and B12 deficiencies? Could this equate to normo?

  • @venkybly
    @venkybly2 жыл бұрын

    Tq

  • @kurootsuki3326
    @kurootsuki33265 жыл бұрын

    saving my grades

  • @HafizahHoshni
    @HafizahHoshni Жыл бұрын

    thank you so much! 27/9/2022

  • @winnieprune4900
    @winnieprune49002 жыл бұрын

    How does liver disease cause macrocytic anaemia? And hypothyroidism? And alcohol?

  • @ahmedalaa-bv8xx
    @ahmedalaa-bv8xx3 жыл бұрын

    A patient with long standing indigestion has noticed increasing lack of energy and tiredness when walking uphill.on questioning he has noticed that the bowl motons are unusually dark from time to time.Due to the indigestion the patient takes a bland diet without much meat or vegetables.(iron deficiency anemia_pernicious anemia)

  • @blacksea2001
    @blacksea20013 жыл бұрын

    Hi I have thalassemia beta how to treatment

  • @IamSomaMohanty
    @IamSomaMohanty2 жыл бұрын

    I am not sure if I will get a response to my query here but I am hopeful. My mother, 58 has declining Hb over time. She has recovered from covid about 5 months ago. During her hospitalization due to covid back in May her Hb was 7.7 and had to under go blood transfusion of 1 unit. The transfusion rose the Hb to 11.2 and after discharge, from followup CBC we found out that the Hb had improved to 12.2. But we would do her CBC every month and in September this month, her Hb has gone down to 10.6 and MCV 85, PCV 36.5. Last month, in October she had fever and we repeated the Hb and found out that it has come down to 9.8. Doctored ordered for B12, vit D3, Ferritin and Iron profile tests. The B12 and D3 are normal. Ferritin is 220 and the TIBC is low 263 and Iron 21.3. During this we also did her Kidney function test and liver function test and the albumin/globulin ratio was 1.23. The doctored suggested her to continue taking Iron supplements and eat protein rich food because she usually follows a vegetarian diet with very low consumption of milk products. Just looking for an answer for her condition. Is it chronic inflammation? Her crp was 4.7 mg/l(nephelometry). Could this be auto-immune disease? That said she is neither diabetic, not has abnormal Thyroid condition. She is not having thalassemia either. No medical surgery, no occult blood in stool.

  • @StrongMed

    @StrongMed

    2 жыл бұрын

    I'm very sorry, but I cannot offer specific, individualized medical advice on this channel.

  • @IamSomaMohanty

    @IamSomaMohanty

    2 жыл бұрын

    @@StrongMed it's alright. Can you do it personally? Can I reach out to you through email?

  • @StrongMed

    @StrongMed

    2 жыл бұрын

    No, I'm very sorry but I cannot. Providing medical advice as a physician requires establishing a doctor-patient relationship, obtaining a full history of the situation by speaking directly with the patient, performing a relevant physical exam (if possible), and reviewing the relevant medical records. This cannot be done safely via email.

  • @mehrshxd
    @mehrshxd2 жыл бұрын

    MY G

  • @XX-ru5wu
    @XX-ru5wu5 жыл бұрын

    *Great!* Greetings from Germany

  • @Shockwave33333333333
    @Shockwave333333333332 жыл бұрын

    2:30 what if its a Hemolytic Anemia?

  • @StrongMed

    @StrongMed

    2 жыл бұрын

    Lesson 3 in this series is all about hemolysis: kzread.info/dash/bejne/fISd2dCyk6vTo5c.html