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.