Anemia due to hemorrhage

Anemia due to hemorrhage

Updated: 7/16/2024

© Jun Wang, MD, PhD

 

General features

Acute hemorrhage

  • Usually normocytic normochromic anemia unless iron reserve depleted or other disorders
  • Initially proportional loss of plasma and red cell mass: little to no change in hemoglobin or hematocrit
  • Presentations associated with volume loss
  • Plasma loss replaced by interstitial fluid rapidly
  • Slower replacement of cellular components leads to lower HGB, HCT, and RBC
  • Reticulocytosis 3-5 days post hemorrhage if adequate iron stores
  • Slightly elevated MCV due to reticulocytosis
  • Microcytic hypochromic anemia after iron reserve depleted, usually after 120 days

Chronic hemorrhage

  • Usually well compensated by increased erythropoiesis
  • Anemia occurs when

o   Rate of loss > rate of regenerative capacity of the marrow

o   Iron reserves depleted

o   Normocytic normochromic anemia unless iron depletion or other underlying disorders

o   Microcytic hypochromic anemia when iron reserves depleted

 

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Contents

Pathology notes Jun Wang, MD, PhD 1. General information Frequently discussed syndromes Terms of dermatology Terms of hematology 2. Primary immunodeficiency disorders 3. Hemodynamic abnormalities Shock Thrombosis and embolism Bleeding disorders 4.  Benign blood cell disorders Anemia Benign white cell disorders 5. Hematopoietic neoplasms Lymphoid neoplasms Myeloid neoplasms Histiocytic neoplasms: Langerhans cell histiocytosis 6. Cardiovascular system Pulmonary hypertension Cardiovascular system tumors 7. Respiratory tract tumors 8. Gastrointestinal tract Congenital disorders Infectious gastroenteritis Oral cavity Esophagus Stomach Intestinal tumors Salivary glands Exocrine pancreas and gallbladder 9. Urinary system Kidney masses Lower urinary tract 10. Male reproductive system 11. Female genital tract 12. Breast 13. Endocrine organs Pituitary gland Adrenal gland Thyroid gland Parathyroid gland Endocrine pancreas M
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Anemia

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Practice questions Anemia I

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Practice questions Anemia I © Jun Wang, MD, PhD   Abbreviations: Hb: hemoglobin HCT: hematocrit MCV: Mean Corpuscular Volume MCHC: Mean Corpuscular Hemoglobin RDW: Red Cell Distribution Width TIBC: total iron binding capacity   1. Use this case for the next three questions . A 25-year-old woman is brought to the emergency department 2 hours after being involved in a motor vehicle accident. She is conscious but feels dizziness and weakness.   Her blood pressure is 90/60 mmHg, and her heart rate is 120 beats per minute. Physical examination reveals pale skin and mucosa and a 15 cm laceration on her left thigh with significant bleeding. What are most likely the CBC and TIBC results? A. Low Hb, low HCT, high MCV, high RDW, high TIBC B. Low Hb, low HCT, slightly low MCV, normal RDW, normal TIBC C. Low Hb, low HCT, slightly high MCV, normal RDW, normal TIBC D. Normal Hb, normal HCT, normal MCV, normal
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