Our first category of anemias, we’ll
be looking at microcytic anemias.
And under microcytic, it
will be iron deficiency.
Think about where you are.
Your MCV is?
Less than 80.
Let’s begin with the
fundamentals, shall we?
We’ll take a look at hemoglobin.
Hemoglobin is made up
of alpha and beta.
That is something that you must know.
Later on at some point, when we talk a
microcytic anemia known as thalassemias,
then we’ll be dealing with those
alphas and betas, but in addition,
we’ll also take a look at your
deltas and gammas, won’t we?
And with hemoglobin,
here, under iron deficiency
and a couple of others,
we’ll be paying attention to
the heme, the heme, the heme.
And so because heme is so tightly
bound or really associated with iron.
You must be familiar with
your iron studies for labs
and you will only be using that for
the most part under microcytic,
and understand what it means when your
iron studies come back to be normal.
with our microcytic anemias,
we’ll take a look at the heme
in which it has now become –
For whatever reason, the porphyria
pathway has then become compromised.
Well, here, at first, it’s literally the
fact that the individual is iron-deficient.
So if the patient’s iron deficient,
this hemoglobin that we’re seeing here,
this molecule, made up of –
What kind of hemoglobin would this be if
it’s alpha and beta, what do you mean?
Is it hemoglobin A? A2?
Is it F? Is it S? Is It C?
Which one is it?
It’s the A, right?
So normal alphas and
betas is hemoglobin A.
You know that.
You should know that.
If you don’t, know it now.
Because we have to talk about
the different hemoglobins.
You’ve heard of hemoglobin S.
You’ve heard of hemoglobin C.
Hemoglobin A2, hemoglobin
F, hemoglobin H, right?
Bart’s and so forth.
There’s a bunch.
Others we’ll take a look at,
anemia of chronic disease,
and the chronicity becomes
of utmost importance.
I’ll tell you how to handle that properly,
so you will not miss a question.
And sideroblastic is rather interesting.
You might have heard of ring
sideroblasts and that ring is iron.
So that is not iron deficiency.
So for those of you that have somehow
only associated iron deficiency
or microcytic anemia as only
being iron deficient.
That is not all correct
because sideroblastic anemia,
if anything, is iron overload.
Are we okay?
We’ll talk more about that.
And what does blast mean to you?
Where are you?
What do I mean where are you?
“I’m at home, Dr. Raj.”
Where are you in terms of the blasts?
In the bone marrow, right?
continuing our discussion
but this time, we’re going
to hit the globins.
And these globins then are
alphas and beta thalassemias.