ANEMIA

• Definition
• Cause
• Signs and Symptoms
• Oral: Vitamin B12, Iron and Acid Folic
• Injections of vitamin B12
• Blood transfusions
• For daily
• For pregnant women

Made by Group 1 and Group 5
DEFINITION
 Anemia is the deficiency condition in the number or
quality of red blood cells(RBC) or the amount of
hemoglobin in the blood.

DEFINITION
 This is a anemia’s test:

DEFINITION
 Reading the anemia’s test:
Anemia happens when blood test has two of three signs:
o Number of red blood cells falls below normal
o Hematocrit falls below the normal
o Hemoglobin level falls below normal

DEFINITION
 WHO’s Hemoglobin thresholds used to define anemia:
(1g/dL = 0.6206 mmol/L)
Age or gender group Hb threshold (g/dl) Hb threshold (mmol/l)
Children (0.5–5.0 years old) 11.0 6.8
Children (5–12 years old) 11.5 7.1
Teens (12–15 years old) 12.0 7.4
Women, non-pregnant
(>15 years old)
12.0 7.4
Women, pregnant 11.0 6.8
Men (>15 years old) 13.0 8.1

CAUSES
Have three type of Anemia:
 Anemia caused by blood loss.
 Anemia caused by decreased or faulty red blood cell
production.
 Anemia caused by destruction of red blood cells.

CAUSES
 Blood loss: include
Blood loss is the most common cause of anemia,
especially iron-deficiency anemia. Blood loss can be
short term (acute bleeding) or persist over time
(chronic bleeding)

CAUSES
 Blood loss:
 Acute bleeding: occur with large amount of blood loss in
short time
Some diseases make acute bleeding:
• Trauma, Large wounds: fractured femur, arterial injury, etc..
• Hemorrhage organ: peptic ulcer heavy, bowel cancer, etc..
• After surgery.
• Menstruation, Postpartum. Or frequent blood donations.

CAUSES
 Blood loss:
 Chronic bleeding: occur slowly over a long period of time,
and can often go undetected.
Some diseases make chronic bleeding:
• Gastric ulcer; Ulcers; Hemorrhoids, and Cancer; Menorrhagia.
• Hookworm injection, chronic diarrhea, dysentery.
• Use of nonsteroidal anti-inflammatory drugs such as aspirin or
ibuprofen, which can cause ulcers and gastritis

CAUSES
 Decreased or faulty red blood cell production:
Produce too few blood cells.
Red blood cells may be faulty.
Decreased due to abnormal red blood cells,
 A lack of minerals and vitamins needed for red blood
cells to work properly.

CAUSES
Conditions associated with these causes:
 Sickle cell anemia
 Iron-deficiency anemia
 Vitamin deficiency
 Bone marrow and stem cell problems
 Other health conditions

CAUSES
 Sickle-cell anemia: is an inherited disorder.
oRed blood cells become crescent-shaped because of a
genetic defect.
oThey break down rapidly, so oxygen does not get to the
body's organs, causing anemia.

CAUSES
 Sickle - cell anemia:

CAUSES
 Iron-deficiency anemia: occurs because of a lack of the
mineral iron in the body.
Bone marrow in the center of the bone needs iron to make
hemoglobin so Without adequate iron, the body cannot
produce enough hemoglobin for red blood cells.

CAUSES
 Iron-deficiency anemia: causes by
 An iron-poor diet: In children anemia can from not eating foods rich in
iron. It can also come from breast-feeding or bottle-feeding a baby after 6
months without giving other foods.
 The metabolic demands of pregnancy and breastfeeding that
deplete a woman's iron stores
 Menstruation

CAUSES
 Iron-deficiency anemia: causes by
 Frequent blood donation
 Changes in the gastric mucosa or gut affects nutrient absorption
(celiac disease)
 Surgical removal of part of the stomach or small intestine
 Certain drugs, foods, and caffeinated drinks

CAUSES
 Vitamin deficiency: occur when vitamin B12 and folic are
deficient. These two vitamins are needed to make red blood
cells.

CAUSES
 Vitamin deficiency: caused by :
 Megaloblastic anemia: Vitamin B12 or folic or both are deficient
 Pernicious anemia: Poor vitamin B12 absorption caused by
conditions such as Crohn's disease (an intestinal parasite infection).
 Surgical removal of part of the stomach or intestine, or infection
with HIV

CAUSES
 Vitamin deficiency: caused by
 Dietary deficiency: Eating little or no meat may cause a lack of
vitamin B12, or eating too few vegetables may cause a folic
deficiency.
 Other causes of vitamin deficiency: pregnancy, certain
medications, alcohol abuse.
During early pregnancy, sufficient folic acid can help prevent the
fetus from developing neural tube defects such as spine bifida.

CAUSES
 Bone marrow and stem cell problems: may prevent the
body from producing enough red blood cells. Because
some of the stem cells found in bone marrow develop
into red blood cells.
If stem cells are too few, defective, or replaced by other
cells such as metastatic cancer cells, anemia may result.

CAUSES
 Bone marrow and stem cell problems: Anemia resulting from
bone marrow or stem cell problems include
 Aplastic anemia occurs when there's a marked reduction in the
number of stem cells or absence of these cells. Aplastic anemia can be
inherited, can occur without apparent cause, or can occur when the
bone marrow is injured by medications, radiation, chemotherapy, or
infection.

CAUSES
 Bone marrow and stem cell problems: Anemia resulting from
bone marrow or stem cell problems include
 Thalassemia: occurs when the red cells can't mature and
grow properly

CAUSES
 Other health conditions: occur when there are too few
hormones necessary for red blood cell production. Causes by:
 Advanced kidney disease
 Hypothyroidism
 Other chronic diseases, such as cancer, infection, lupus,
diabetes, and rheumatoid arthritis
 Old age

CAUSES
 Destruction of red blood cells:
When red blood cells are fragile and cannot withstand the
routine stress of the circulatory system, they may rupture
prematurely, causing hemolytic anemia. Hemolytic anemia
can be present at birth or develop later. Sometimes there
is no known cause.

CAUSES
 Destruction of red blood cells: Causes by
 Inherited disorders, such as: thalassemia or sickle cell
disease,…
 Autoimmune disorders, such as: autoimmune hemolytic
anemia, where the immune cells attack the red blood cells and
decrease their life span.
 Infection. Such as malaria and septicemia, which reduce the
life span of red blood cells.

SIGNS and SYMPTOMS

SIGNS and SYMPTOMS
 Mild anemia: no sign. If the disease progresses slowly,
the initial symptoms may include:
 Often weak or tired, or when exercising.
 Headache.
 Unfocused thoughts.

SIGNS and SYMPTOMS
 Severe anemia:
 Pale or transparent skin.
 Pale inside of eyelids.
 Pale gums.
 White fingernails, brittle
 Easy hair loss.

SIGNS and SYMPTOMS
 Severe anemia:
 Heart: rapid, may have a systolic murmur.
 Respiratory: shortness of breath.
 Nervous: headache, dizziness, fainting
 Digestive disorders, poor feeding, tongue pain
 Menstrual disorders in women or decreased sexual
ability in men

SIGNS and SYMPTOMS
 Severe anemia:
 If anemia is very severe, face and feet may be
swollen, memory loss, can lead to coma.

 Treatment of Anemia based on the Cause and Severity.
 Vitamin B12, Iron and Acid Folic are the deficient vitamins in
the Anemia. They are supplied by orally or injection
(just for vitamin B12).
 There is some ways to treat of Anemia.
 Oral Vitamin B12, Iron and Acid Folic. (for mild anemia)
 Injection of vitamin B12 (intramuscularly).
 Blood transfusions.

ORAL IRON
 Treated by oral iron supplementation with ferrous sulfate,
ferrous fumarate, or ferrous gluconate.
 When using iron supplements, the stomach upset can be
alleviated by taking the iron with food; however, this decreases
the amount of iron absorbed.
 Vitamin C aids in the body's ability to absorb iron, so taking
oral iron supplements with orange juice is of benefit.

ORAL IRON
 Large amounts of iron can be harmful, so take iron
supplements only as your doctor prescribes.
 Dosage: (tablet 200mg)
- Adults: Each 200 - 400 mg (1-2 tablets), day 3 times
- Children over 6 years: Each 200 mg (1 tablet), day 3 times.
- Children under 3 years old: Every time 25 - 50mg
(1/8 to 1/4 tablet) 3 times day (use with food).
- Type with 200mg 5ml syrup, used as directed by a doctor.

ORAL IRON

ORAL VITAMIN B12 and ACID FOLIC

INJECTION OF VITAMIN B12

 DOSAGE:
- Pernicious anemia no nerve damage:
1000 mg for 1-2 weeks, then 250 mg injections per week until
the blood is considered normal.
Maintenance dose: 1000 mg per month.

 DOSAGE:
- Pernicious anemia have nerve damage:
1000 mg per day until improvement.
Maintenance dose: 1000 mg per month.
- Anemia after gastric resection or hookworm:
250-1000 mg per month.

BLOOD TRANSFUTION
 In case of the Acute anemia; Thalassemia;
Aplastic anemia. When hemoglobin is below 60 to 80 g/L
(6 to 8 g/dL)
 NOTICE:
Transfuse true Blood types and true blood flow rate

Some things should be avoided
the treatment of Amenia
 You should not be iron supplement without the doctor’s
advice and dietitian.
 You should avoid the drugs which reduce stomach acid
such as Cimetidine (Tagamet)… because it may reduce
the absorption of iron.

for Daily
• Vitamin B12
• Acid folic
• Iron
for Pregnant
women
• Deficiency
• Requirement
• Effect to baby

FOR DAILY
 Vitamin B12:
 Vitamin B12 is important for the way the body works.
 Vitamin B12 helps in the production of healthy red blood cells that
carry oxygen around the body.
 Vitamin B12 in general help your body make protein and energy.
 Vitamin B12 is found in most animal derived foods, including fish
and shellfish, meat (especially liver), poultry, eggs, milk, and
milk products.

FOR DAILY
 Vitamin B12:
 Vitamin B12 daily requirement in adult is 2.4 microgram,
and older person need more because vitamin B12 helps for
the time of brain atrophy decrease.
FOOD REQUIREMENT (microgram)
Beef 2 - 8
Bovine kidney 20 - 50
Beef liver 30 - 130
Milk 0.2 – 0.6
Polk meat 0.1 - 5
Yolk egg 1.2

Vitamin B12: 2 – 8 mcg Vitamin B12: 20 – 50 mcg
Vitamin B12: 30 – 130 mcg

Vitamin B12: 0.1 – 5 mcg Vitamin B12: 1.2 mcg
Vitamin B12: 0.2 – 0.6 mcg

FOR DAILY
 Acid folic:
 Acid folic daily requirement in adult is 400 microgram
 Acid folic when combined with Vitamin B12 helps
produce red blood cells - reduces the risk of suffering
from anemia.
 Acid folic is found in Citrus fruits and juices;
Breads, cereals & grains;
Dark green leafy vegetables

FOR DAILY
 Acid folic:

FOR DAILY
IRON:
 Iron is important vitamin for product blood. So you need eating
iron-rich food for every diet.

FOR DAILY
 IRON:

FOR DAILY

FOR PREGNANT WOMEN
 Why do pregnant women need more?
- During pregnancy, your body produces more blood to support
the growth of your baby
- When you have anemia, your blood doesn't have enough
healthy red blood cells to carry oxygen to your tissues and to
your baby.
-If you're not getting enough iron or certain other nutrients, your
body might not be able to produce the amount of red blood cells.

FOR PREGNANT WOMEN
 Why do pregnant women need more?
- It's normal to have mild anemia when you are pregnant.
- Anemia can make you feeling tired and weak. If it is severe
andit isn’t treated, it can increase your risk of serious
complications like miscarriage, stillbirth, preterm delivery,
postpartum haemorrhage.

FOR PREGNANT WOMEN
 Requirement pregnant women need.
- Pregnant women need more than normal person.
- Pregnant women need 400mcg Acid folic and 60mg Iron
during pregnancy and after birth 1 month.
- First 3 months of pregnancy is the good time to the mother
should supplements acid folic.
- From fourth month to sixth month, the mother and baby need
more iron.

FOR PREGNANT WOMEN
 Effecting to baby:
- Folic acid reduces the chance for certain birth defects to
occur (such as spine bifida and cleft lip/palate) when the
mother don’t take acid folic.
- Anemia cause fetal malnutrition, low birth sign, premature
birth.
- The baby weak, low resistance, poor brain development.

ANEMIA

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ANEMIA