#52: Anemia: Tips, and tools for diagnosis and treatment
Master the anemia algorithm, and take a deep dive on iron deficiency, anemia of chronic kidney disease, anemia of chronic inflammation, causes of macrocytic anemia and more in this discussion with international expert, Dr. David P. Steensma, Senior Physician from Dana Farber Institute, and Associate Professor of Medicine at Harvard Medical School.
Full show notes available at http://thecurbsiders.com/podcast
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Cases from Kashlak Memorial:
- 62 yo M with diabetes and CKD with asymptomatic Hgb 10, MCV 90, and Cr. 1.9?
- 72 yo F with HTN with asymptomatic Hgb of 11, MCV 85 and Cr. 0.6.
- 72 yo F with breast cancer in remission after lumpectomy, adjuvant chemo, and XRT treated 6 years ago presents with fatigue and some dyspnea on exertion. Hgb 9.6, MCV 102.
Time Stamps
00:00 Intro
01:18 Listener feedback
04:05 Announcement: We’re looking for on air correspondents to join The Curbsiders
05:05 Picks of the week
11:12 Getting to know our guest
17:50 Case #1 Normocytic anemia
19:15 Defining anemia (WHO criteria)
21:10 Epidemiology of anemia
23:45 Normocytic anemia
25:55 Erythropoietin for diagnosis and treatment
28:22 Anemia of CKD or chronic inflammation?
31:37 Discussion of ferritin and soluble transferrin receptor
33:47 Case #1 Conclusion
35:45 Hemoglobin targets in CKD
36:53 Case #2 Microcytic anemia
37:43 Correct reticulocyte count and reticulocyte index
40:45 Deciding on dose and route for iron repletion
43:44 Does vitamin C improve iron absorption?
45:27 Case #3 Macrocytic anemia
46:54 Vitamin B12 deficiency
51:54 Medication related B12 deficiency
52:35 Myelodysplastic syndrome
55:00 Side effects of common MDS treatments
56:18 Take home points
57:35 The Curbsiders post game analysis
64:16 Outro
Tags: anemia, hemoglobin, i