I always feel tired

Anemia
1. A condition in which there is a deficiency of red blood cells or haemoglobin in the blood resulting in pallor and weakness.
  1. Hemoglobin
    1. Heme
      1. Iron
        Iron deficiency
        Iron metabolism
      2. Porphyrin
        Porphyria
    2. Globin
      1. Issues involved with glovin
        Thalassemia
        Sickle cell anemia
2. Anemia symptoms
  1. Tissue hypoxia
    1. Dizziness
    2. Heart
      1. Chest pain
      2. Angina
      3. Heart attack
    3. Lung
      1. Dyspnea
      2. Low oxygen reserve
    4. Muscles
      1. Fatigue and weakness
3. Types identified based on CBC
  1. Mean corpuscular Volume (MCV)
    1. Macrocytic anemia
      1. Vitamin B12 deficiency
      2. Folate deficiency
      3. Liver disease
      4. Alcoholism
    2. Microcytic anemia
      1. Iron deficiency
      2. Anemia of chronic disease
      3. Sideroblastic anemia
    3. Normocytic
      1. Aplastic anemia
      2. Hemolytic anemia
      3. Renal disease
      4. Acute blood loss
  2. Other problems involving RBCs
    1. Maturation
      1. Megaloblastic anemia
    2. Number
      1. Hemolytic anemia
        Immune
        Infectious
    3. Structure
      1. Hereditary spherocytosis
4. RBC indices
  1. MCV
  2. MCH
  3. MCHC
Life span of RBCs
1. Erythropoiesis in BM
  1. Differentiation of stem cells to mature cells is associated with
    1. Hemoglobin production
    2. Decreasing cell size
    3. Gradual decrease and loss of organeles
    4. Condensation and eventual extrusion of the nucleus
    5. Changing cytoplasmic staining
History taking
1. What to ask a patient when he complains of tiredness and dyspnea
2. Onset. Duration. Progress
  1. Ask about trauma
3. Age and Sex
  1. Different Natural HB levels
4. Associated symptoms
  1. Pain
  2. Bleeding
  3. Ulcer
  4. Cancer
5. Occupation
6. Family history
  1. Thalassemia or sickle cell
7. History of chronic illness
8. History of GIT
  1. Bleeding or surgery
9. Changes in body weight
10. Changes in bowel habits
11. Any complaints of Abnormal urine color
  1. Renal and hepatic disease
12. Diet
  1. Vegetarian
  2. Vegan
  3. Iron
  4. B12
  5. FOLATE
13. Drug ingestion
  1. NSAIDS
14. Previous CBC
CBC
1. Hematocrit
  1. Volume of RBC from total blood volume
2. Hb
  1. Presence of Anemia
3. Platelet count
4. WBC count
  1. Infection
5. RBC count

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I always feel tired

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