eytanraz
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Diagnosis of anemia, everyone says different things.
Male: below 13 g/dL
Female: below 12 g/dL
Do u agree with these values?
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| AAAAA
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Who cares everyone says different things ?
It is YOU who read the books not review books to make up your mind !
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| AAAAA
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Do not read review books until you finish Harrision Internal Medicine !!
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| AAAAA
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Do you know in 2006, most of the medical examinations are taken on the computer terminals.
Just one click, all the value of anemia index will show up on the left side of the screen of the computer.
That's the value you go by.
Are you a doctor prepare for USMLE ? Computer terminals are the exam tools in 2006 !
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| eytanraz
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I asked you about these values, I didn't ask u to judge if my question was important or not.
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| achilles
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hematocrit < 41%(males) and < 37%(females) or hemoglobin <13.5mg/dl(males) or 12mg/dl(females) would generally be regarded as anemia.
and well, just a simple question for review - death from anemia is most commonly from what reason ?
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| chemamr
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eytanraz: Lab values vary according to the book you read or even the laboratory you go.
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| drk1980
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@ achilles: high output cardiac failure??
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| drsap
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myocardial infarction is MC COD in anemia.
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| Diego Casali
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Kaplan Internal Medicine Notes and Goljan's Most Commons in Medicine agree that a hematocrit less than 40 in men or less than 37 in women, or a hemoglobin less than 13 in men or less than 12 in women is anemia.
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| AAAAA
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It is meaningless because it depends on mg/L or gm/L.
Also they provides the values for you in the USMLE !
I have taken USMLE, British medical exam, Canadian exam and all give you the numbers.
I recently took the exam in the computer terminals and all the values come up in one click !
So don't worry about the values.
I was in practice in 1989 and I worried so much about the patient's anemia with hemoglobin of 10. He is a chronic renal failure failure and has no insurance.
There is nothing you can do except to give him Procrit ! (but he can not afford the med.)
Also you need to know what kind of anemia and how to make the diagnosis.
What is 300 of iron binding capacity means to you ?
What is Hct over 55 in a male patient means to you?
So if you wants to pass USMLE, go beyond this values and study about what does 300 iron binding capacity means to you ?
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| AAAAA
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I am very strong against anyone to prepare for USMLE using just the review books.
You need a real textbook to study from A to Z like Cecil or Harrison !
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| AAAAA
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ANEMIA: A lower than normal number of red blood cells
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| AAAAA
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Therefore, a pragmatic definition of anemia is a state which exists when the hemoglobin is less than 12 g/dL or the hematocrit is less than 37 cL/L. Anemia may exist as a laboratory finding in a subjectively healthy individual, because the body can, within limits, compensate for the decreased red cell mass.
One must be careful in blindly applying this practical definition of anemia in every case. As the following diagram shows, it is possible to be severely anemic and have a normal hematocrit (and hemoglobin). This occurs when there is rapid hemorrhage, with red cells and plasma being rapidly lost simultaneously, before the body can respond by hiking up the plasma volume.
The final example in the above diagram illustrates that a person can have a low hematocrit and not be anemic. This occurs when a patient is overhydrated, typically as a result of overenthusiastic intravenous fluid therapy.
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| AAAAA
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Please review the clinical symptoms and not just make the assumption the pt is anemia based on those numbers.
Attached Files:
rbc_volume.gif (6 KB, 8 downloads)
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| AAAAA
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eytanraz wrote:
Diagnosis of anemia, everyone says different things.
Male: below 13 g/dL
Female: below 12 g/dL
Do u agree with these values?
If you ask 10 different doctors about the treatment of rheumatoid arthritis using anti-TNF, they will tell you ten different criteria !
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| AAAAA
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The World Health Organization (WHO) defines the lower limit of normal for males older than 14 living at sea level as 13 g/dl (130 mg/dl) and in nonpregnant female 12 g/dl (120 mg/dl).
(Thanks I did some research into the definition of WHO of anemia)
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| AAAAA
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Although there are over 400 different forms of anemia, this health profile will only address the three most common: iron-deficiency anemia, vitamin B12 anemia and folic acid deficiency
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| eytanraz
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finally, thanks you all, especially AAA. The diagram was very direct! Eyt
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| AAAAA
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Dr. Eytanraz,
It is not that simple. I am going to tell you the number means NOTHING, NOTHING AT ALL.
WHEN YOU DO TRANSFUSE AN ANEMIC PATIENT ?
If the pt reaches hemoglobin 12 g/dL, 9 g/dL, 7 g/dL in the ICU and is recovering and doing well except very anemic ?
What do you do ?
Table 1: Indication for Transfusion of PRBCs
Evidence of significant blood loss (e.g., SBP < 90 mmHg, obvious hemorrhagic shock)
Hgb < 9 g/dL (Hct < 27%) with clinical sequelae including:
- Hypovolemia
- Hypoxia or poor oxygen delivery to tissue (e.g., arterial oxygen saturation < 90%, lactic acid > 3, base deficit > 5)
- Acute myocardial ischemia or acute decompensation of congestive heart failure
Hgb £ 7g/dL (Hct £ 21%) without significant heart, lung, vascular, renal, or neural disease
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| AAAAA
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eytanraz wrote:
finally, thanks you all, especially AAA.AA The diagram was very direct! Eyt
It makes no difference of the hemoglobin or hematocrit if the patient is actively bleeding, transfuse.
If the pt has unstable cardiovascular diseases and reaches 9 gm/dl, you transfuse.
But even the pt is very anemic at 7 gm/dl and is stable in ICU, you don't do anything. NOTHING, NOTHING SHOULD BE DONE !
So doctor, the number means NOTHING.
We must use our brain to think, think about the clinical situation and then decide what the numbers mean!!!
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| alenka
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AAAAA-i'm very jealous of you-you seem to have so much time to write all these huge messages in here.
when do you study?
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| AAAAA
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I have an oral exam tomorrow !
But I am going to go to sleep and I put in 14 hours of work over the weekend !!
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| AAAAA
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Work means real work ! LOL !!
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| AAAAA
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I am married and have a family and a lot of responsibility too !
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