Diagnosis

Acute or chronic blood loss is one of the first considerations in the search for the causes. The diagnosis is usually based on the patient history, physical examinations and a stool test for occult blood (Haemoccult test). Sometimes, however, further tests on occult bleeding are necessary.

Anemia is strictly speaking not a diagnosis, but the manifestation of an underlying disease. Therefore, it should also searched for the presence of a minor, asymptomatic anemia after the primary disease, and they are treated. Acute or chronic blood loss is one of the first considerations in the search for the causes. The diagnosis is usually based on the patient history, physical examinations and a stool test for occult blood (Haemoccult test). Sometimes, however, further tests on occult bleeding are necessary. If no blood loss can be detected, laboratory tests are performed to determine if the anemia is caused by the reduced erythropoiesis or excessive hemolysis. The history of the medical history should focus particularly on risk factors for the development of anemia, the symptoms of anemia itself and symptoms belonging to the underlying disease. There are many risk factors for anemia. For example, predisposes a vegan lifestyle for a vitamin B12 deficiency anemia, while alcoholism is associated with an increased risk of anemia by folic acid deficiency. Some hemoglobinopathies are innate; various drugs can promote hemolysis. Malignant, rheumatic and chronic inflammatory diseases can lead to a suppression of bone marrow activity or splenomegaly. The clinical symptoms of anemia are helpful in differentiating the various forms of anemia not specific or. The symptoms are an expression of compensation mechanisms in tissue hypoxia and develop normally, if the hemoglobin level to <7 g / dl drop. Nevertheless, they can occur in patients with higher hemoglobin levels already, z. As in patients with cardiopulmonary reserve or if the anemia develops very quickly. Symptoms such as weakness, spot vision, fatigue, malaise, anginal pain, syncope or exertion may indicate anemia. Furthermore, it can be used for training of dizziness, headache, pulsatile tinnitus, amenorrhea, loss of libido or gastrointestinal symptoms occur. In patients with severe tissue hypoxia or hypovolemia heart failure or shock may occur. However, some symptoms can already point to the cause of anemia. For example exhibit. B. tarry stools, epistaxis, hematochezia, hematemesis or menorrhagia of bleeding out. Jaundice and dark urine suggests without liver disease to hemolysis in Patienen. Weight loss can be a sign of a tumor disease. A sickle cell disease manifests itself in circumstances in the form of strong bone or chest pain. A vitamin B12 or folate deficiency may be conspicuous by paresthesia of the distal extremities. Physical examination A complete physical examination is essential. The clinical signs of anemia are not specific, but often found in severe anemia pallor. Often the clinical signs of the underlying disease are diagnostic groundbreaking as the signs of anemia itself. Positive Haemoccult tests indicate a gastrointestinal bleeding. Acute bleeding is a haemorrhagic shock (e.g., hypotension, tachycardia, pallor, tachypnea, sweating, confusion; s shock..) Have the effect. Jaundice can be a symptom of hemolysis. Splenomegaly can occur in hemolysis, but also with hemoglobinopathies, connective tissue disease, myeloproliferative disease, infections and tumors. Peripheral neuropathy refers to a vitamin B12 deficiency. A bloated abdomen in a patient with blunt trauma is an indication of acute bleeding. Petechiae form during thrombocytopenia or platelet dysfunction. Fever and heart murmur may indicate infective endocarditis as a possible cause of hemolysis. In rare cases, a high-output heart failure develops as a compensatory response to anemia-induced tissue hypoxia. Laboratory tests Peripheral blood smear, normal with permission of the publisher. From Tefferi A., Li C. In Atlas of Clinical Hematology. Edited by J. O. Armitage. Philadelphia, Current Medicine, 2004. var model = {thumbnailUrl: '/-/media/manual/professional/images/peripheral_blood_smear_normal_high_de.jpg?la=de&thn=0&mw=350' imageUrl: '/ - / media / manual / professional / ? images / peripheral_blood_smear_normal_high_de.jpg lang = en & thn = 0 ', title:' Peripheral blood smear, normal ', description:' u003Ca id = "v38395958 " class = ""anchor "" u003e u003c / a u003e u003cdiv class = ""para "" u003e u003cp u003eEin drop of blood is placed on a microscope slide and then with polychrome colorants (Wright-Giemsa) stained to detect the different cell types. These coloring agents are mixtures of blue

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