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The next topic is about normocytic and non-hemolytic anemias that do not have increases in
their reticulocyte counts. In acute blood loss, there will be no initial change in hemoglobin
levels unless you give isotonic saline. Saline is NaCl. So what you're going to do? You will now
unveil the anemia in your patient, but they will appear to be normocytic, nonhemolytic. Early
stage iron disease, iron studies abnormal at first. That's the first thing. The studies will be
abnormal but in terms of early type of peripheral blood smear, it will be normocytic early. So
the first thing that you're looking for is, then once again. Serum iron decreased, ferritin
decreased, TIBC increased, oxygen saturation percentage decreased. And that's 4 words that
walk through in great detail. Now, the anemia of chronic disease, we talked about how the
bone marrow might be compromised in normocytic and often remains normocytic and we saw
this early microcytic. Aplastic and pancytopenia so you can't produce much of your myeloid
lineage. Renal disease, decreased EPO. Malignancy, may result in normocytic non-hemolytic
anemia. Remember malignancy could have been an underlying issue, chronically for anemia
of chronic disease (ACD). I give you breast cancer metastasizing into your bone marrow and
that we called ___. Normocytic non-hemolytic is my point. And then bleeding. Bleeding
might be taking place into different structures and therefore may result in anemia as well.
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Malignancy is a big one.