1. Definition: Reduced Hemoglobin concentration in blood lower than the normal level, relative to the age, sex, race, and physiological status.

2. The importance of history taking and clinical examination in diagnosing anemia 3. Normal range for Hb and RBCHb (g/L) Males :RBC (10^12/L) 120 160g/L 4.0-5.5Females:110 1503.5 5.5Neonates:170 2006.0 - 7.0 4. General Mechanisms 1.RBC loss without RBC destruction 2.Deficient RBC production: Bone Marrow Failure 3.Increased RBC over destruction : Hemolysis 5. History taking: It is the process of gathering information from the patient. Ask the patients address? Age? What type of work the patient does? Previous illnesses? The presenting complaint? 6. Diagnosis of Anemia Diet : Tea/ coffee intake? Chelating agents.Vegetarian or lack of leafy greens? Intake of folic acid effect growth rate Iron intake effects hemoglobin levels. Pregnant? Dividing nutrients between two people. 7. Surgical history : What surgeries have been performed? Surgeries cause lots of blood loss. Surgery cutting the ileum.Glucose 6 Phosphate Dehydrogenase deficiency occurs after surgeries. Essential in RBC metabolism. 8. Blood : Menstruation, chronic bleeding, blood donation, concealed bleeding hemorrhage can cause more iron deficiency 9. Drug History: NSAIDS ex: Aspirin, Corticosteroids, Warfarin Family History : Hemolytic anemia, Pernicious anemia, Sickle cell disease. Social History : Alcohol intake? Smoker? Both increase the stomach acidity which can irritate a peptic ulcers which cause internal bleeding. 10. Physical Examination Evaluate conjunctiva and mucous membranes for paleness Cardiovascular system for murmurLiver Spleen Look for jaundice or purpura 11. Symptoms Easy fatigue and loss of energy Rapid heart beat, Shortness of breath and headacheDifficulty concentrating 12. Brittle nails Koilonychia (spoon shaped nails) Angular stomatitis Brittle hairGlossitis, Atrophy of paillae of the tongue 13. Dizziness Pale skinLeg cramps 14. Special thanks toDr. K. D. Mahinda