hematology and oncology
Evaluation of Anemia
Patient History in Anemia
The history should address Risk factors for particular anemias Symptoms of anemia itself Symptoms that reflect the underlying disorder Anemia has many risk factors. For example, a vegan diet predisposes to Megaloblastic Macrocytic Anemias , whereas alcohol use disorder increases the risk of The symptoms of anemia are neither sensitive nor specific and do not help differentiate between types of anemias. Symptoms reflect compensatory responses to tissue hypoxia and usually develop when the hemoglobin level falls well below the patient's individual baseline. Symptoms are generally more pronounced in patients with limited cardiopulmonary reserve or when the anemia develops very rapidly. Symptoms such as weakness, fatigue, drowsiness, angina, syncope, and dyspnea on exertion can indicate anemia. Vertigo, headache, pulsatile tinnitus, amenorrhea, loss of libido, and gastrointestinal (GI) complaints may also occur. Heart failure or shock can develop in patients with severe tissue hypoxia or hypovolemia. Certain symptoms may suggest the cause of the anemia. For example, melena, epistaxis, hematochezia, hematemesis, or menorrhagia indicates bleeding. Jaundice and dark urine, in the absence of liver disease, suggest hemolysis. Weight loss may suggest cancer. Diffuse severe bone or chest pain may suggest Sickle Cell Disease , and stocking-glove paresthesias may suggest 