Anemia 7: Diagnostic of Anemia

To establish the diagnosis etiologic required; (a). anamnesis (b). Physical examination (c). Laboratory examination (d). Special examination (e). sometimes - sometimes with adjuvantivus therapy (treatment experiment monitored ago respond). (Petit, J.E., 1996).

1) Anamnesis
Anamnesis can give instructions about the cause of anemia;
- Loss of blood can be epitaxy's history, hemoptisis, hematemesis, melena, hematuria, menoragia, metroragia, or Pica (really want to eat ice, clay, or laundry starch used).
- Diet bad, alcohol abuse, stomatitis tongue, parestesia, difficulty walking, or diarrhea with feces smell oily.
- Historical Exposure to drugs or poisons.
- History of cancer, chronic infection.
- Historical fever, decrease in body weight, bone pain, or masses may indicate cancer as a cause of anemia. (Petit, J.E., 1996).

2) physical examination
- Pallor, which appear on the face and lips when anemia and weight more clearly on mucosa conjunctiva.
- Oral examination may reveal stomatitis angularity, glositis, atrophy tongue and breath odor uremia.
- Checking the stomach can hepatomegali, splenomegali, mass, or asites.
- Checking rectum and pelvis can find the source of bleeding.
- Bone pain or limfadenopati can give you instructions of cancer. (Petit, J.E., 1996).

3) Inspection Laboratory. (Bunn, H.F, (2000).
a) an accurate measurement of hemoglobin concentration, and hematokrit calculated red blood cell (RBC) allows the red blood cell index which is very useful to characterize anemia.

b) red blood cell Index: Mean Corpuscular Volume (MCV), Mean Corpuscular hemoglobin (MCH), Mean Corpuscular hemoglobin Concentration (MCHC). Index red blood cells can give abnormalities allegations that underlie before anemia, which is determined previously developed.
o MCV = Mean Corpuscular Volume (Volume Corpuscular Average - the average) is a measure of the size of the cells and to declare a change - change the size of the cells.
MCV = Hmt: RBC (in fentoliter (fl)
o MCH = Mean Corpuscular hemoglobin (Hemoglobin Corpuscular Average - the average) is the size of the average amount of hemoglobin in each unit cell.
MCH = Hb: RBC (in pictogram (pg)
o MCHC = Mean Corpuscular Concentration hemoglobin (hemoglobin concentration Corpuscular average) is the size of the concentration of hemoglobin in each cell (size kromositas).
MCHC = Hb: Hmt (in gram/100 ml RBC, g / dl RBC) (Petit, JE, 1996).

c) Calculate Retikulosit, useful to distinguish the anemia secondary to the production of red blood cells are low or by hemolisis.
d) Calculate Leukocyte and Trombosit, can help to distinguish genuine or pansitopenia anemia, leukemia, and hipersplenisme.

e) Checking apusan blood that can ensure the size and color of the blood cells that can reveal the variation in cell size (anisositosis) or form (poikilositosis) blood red.

f) bone marrow examination, it is often useful and important in the anemia is not clear.

g) Inspection Serum iron, Total Iron Binding Capacity (TIBC), LDH, BUN, Total bilirubin Total protein and a useful comparison in the determination of various types of anemia caused by different etiology.

4) special inspection
This type of inspection is done only on the indications in order to find the right movement of the anemia, after checking the filter on the category. (T, brace, L., 2000).