Clinical QuickieHematology/Coagulation
Anemia — First-Pass Interpretation
Anemia is a finding. The first job is to classify the mechanism.
Start with the trend
Compare with baseline and rate of decline. Acute blood loss and chronic underproduction behave differently.
Use MCV to organize, not diagnose
Microcytic, normocytic and macrocytic patterns narrow the differential but do not replace reticulocytes, iron studies, B12/folate testing or bleeding evaluation.
Reticulocytes tell you marrow response
An appropriate response supports blood loss/hemolysis; an inadequate response points toward underproduction or impaired marrow response.
Symptoms change urgency
Dyspnea, chest pain, syncope, hemodynamic instability, active bleeding or rapid decline matter more than the isolated hemoglobin.
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