# Anemia --- **Anemia** is a [[disease|condition]] where you have unhealthy [[red blood cells]], or you just don't have enough of them. There are many causes to anemia, and they can be broken down into many different categories. For the purposes of these notes we will break them down first by how they effect the *size* of the red blood cells. The lab value that returns the size of the RBC is the "mean corpuscular volume" or the the MCV, which is run in a [[complete blood count#RBC Indices|CBC]]. - based on MCV - microcytic, normocytic or macrocytic - **Macrocytic anemias** are when the blood cells are too big (🥄) to do their job properly. There are further differentiated based on the presence of **megaloblasts**, or these particular large, misshapen RBC precursors - **megaloblastic** examples are: - [[vitamin B|folate]] deficiency - **Pernicious anemia** arises from a lack of [[gastric gland#Parietal Cells|intrinsic factor]] helps the intestines absorb B12. - **Non-megaloblast anemia** results from [[liver]] disfunction, alcoholism, myelodysplastic syndrome or [[hypothyroidism]] - **Microcytic anemias** are when the RBCs are too small - [[iron deficiency#Stage 3 Anemia|iron-deficiency anemia]] arises from a lack of dietary iron, and is the most common cause of microcytic anemia - hyperproliferative vs hypoproliferative - when not enough RBCs are being produced, or they're being over produced - **aplastic anemia** is a type of *hypoproliferative* anemia - body stops making red blood cells usually due to some sort of damage to the [[bone marrow]] - happens after chemo a lot of the time, or from chemical exposure - hemolytic vs non-hemolytic - when RBCs are extra fragile (like [[sickle cell disease|sickled cells]]) or are otherwise destroyed - a high reticulocyte count suggests hemolytic anemia - hemoglobin content - i.e. hypochromatic vs normochromatic vs hyperchromatic - [[iron deficiency|iron-deficiency anemia]] is often also *hypo*chromatic - [[thalassemia]] is an example of *hyper* chromatic RBCs. ![[anemia MCV.png]] Doctors look at multiple qualities of the blood in order to determine the exact cause of the anemia. For example, this is the tree to determine microcytic anemias: ![[microcytic anemia.png]] ## Anemia During Pregnancy [[pregnancy|Pregnant]] people generally have a mild anemia, which arises from their increased total blood volume, as well as the fact that the fetus takes up a lot of the resources. This "pseudo anemia" peaks at weeks 30-34. ___