Normocytic Anemia: Classification

00:00 Under normocytic classification, normocytic, acute blood loss.

00:05 Decreased RBC production.

00:07 No reticulocytosis.

00:08 Where am I? Good.

00:11 This is normocytic non-hemolytic anemia.

00:13 "But Dr. Raj, will acute blood loss be destruction of RBC?" Sure, but where? On the floor.

00:20 So if you lost your blood, the floor doesn’t count as being intra or extravascular hemolysis.

00:26 When you literally have lost the blood from your body, it’s still going to be non-hemolytic.

00:31 Is that clear? So because you destroyed the RBC once they hit the floor, that doesn’t count.

00:36 You don’t call it hemolysis.

00:39 So our topic here is normocytic non-hemolytic anemia.

00:42 Acute, acute, acute blood loss is a point here.

00:46 In addition, RBC production decreased.

00:49 So what’s your reticulocytosis? Decreased.

00:51 What’s your magic number? Corrected reticulocyte count less than 3%.

00:55 Aplastic anemia.

00:57 Anemia of renal disease.

00:58 What does this mean? No EPO.

01:00 Myelophthisic.

01:01 What does that mean? Well, we’re going to come into a lot of pathologies that use the word myelo, myelo, myelo, right? You’ve heard of myelodysplastic syndrome.

01:09 You’ve heard of myelofibrosis.

01:10 This is myelophthisic.

01:11 We’ll take a look at myeloproliferative.

01:13 And each one of those become important.

01:15 Let’s begin just bit by bit by bit.

01:18 Myelophthisic anemia means that the bone marrow has been absolutely compromised.

01:25 There is space occupying lesion in the bone marrow.

01:27 Remember that patient that I gave you breast cancer? It might metastasize in the bone marrow resulting in bone marrow shutdown.

01:35 What kind of anemia please? Normocytic non-hemolytic low reticulocyte production index.

01:41 If it’s increased RBC loss, it’s the opposite.

01:45 These are hemolytic anemias.

01:46 And then, what is the magic question you ask yourself? Is the RBC being destroyed within the vasculature? What’s your major, major symptom there? Good.

01:55 Hemoglobinuria.

01:56 If it’s extravascular, what's your major significant sign there? And that will be your jaundice or even cholelithiasis, pigment stones.