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    67 views26 pages

    Anemias 3399531

    Uploaded by

    Ken-y Roy Valencia

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    - AEC - A. de IRC. - Ferropenia precoz -Leucemia -A. aplsica. -Infecciones MEGAL OBLSTICAS - Dficit B12 - Dficit folatos NO MEGALOBLSTICAS - Hepatopata - Hipotiroidis mo - Abuso alcohol - Reticulocitosis - S. Mielodisplsicos Hemorragia Anemias hemo lticas: - AH corpusculares: Enzimopatias Membranopatias Hemoglobinopatia - AH aut oinmunes - A. microangioptica Hb13g/dl hombres Hb12g/dl mujeres y nios 6-14a. Hb11g/d l gestantes y nios 1-6a. Valor VCM VCM 80 fl VCM 80-100 fl VCM 100 fl A. micr octica A. normoctica A. macroctica </li><li>ANEMIA NORMOCITICA DIAGNSTICO DIFER ENCIAL DETERMINACIN RETICULOCITOS Reticulocitos bajos/ N Ferropenia No ferropeni a Reticulocitos elevados Anemia sangrado agudo Investigar causa y repercusin hem odinmica Descartado sangrado agudo Anemia hemoltica IC hematologa Anemia ferrpnica in icial AEC con ferropenia AEC Con clinica de EC VSG ,PCR IRC, endocrinopatia AEC Sin clnica asociada VB12, flico N Bi/pancitopenia Determinacin B12 y ac flico VB12 y /o flico A. megaloblstica SMD, aplasia medular </li><li>ANEMIAS MICROCITICAS ALGOR ITMO DIAGNOSTICO Determinar ferritina, fe, transferrina Ferritina disminuida Ane nia ferropnica Estudio diagnstico Ferritina normal Hierro normal o elevado Transfe rrina normal Elevadas Determinacin Hb A2 y F Talasemia Hierro disminuido Transf errina normal o Anemia por enfermedad crnica Orientacin diagnstica ANEMIA MICROCTI CA Normales IC hematologia </li><li>ANEMIA MICROCTICA PARMETROS ANALTICOS A.MICROCI T. FERRITINA HIERRO TRANSF IST Hb A2 y F Ferropnica Baja Bajo Alta Bajo(&lt;16%) Normales talasemia Normal Normal Normal Normal Alta(s) Enf. crnica Alta /Norm al ajo /Normal aja Normal o bajo Normales Sideroblstica Alta Alto Normal Alto N ormal </li><li>ANEMIA FERROPNICA <ul><li>Anemia ms frecuente en prctica clnica. </li ></ul><ul><li>Fisiologa: equilibrio aporte hierro vs prdidas. </li></ul><ul><li>Et iologa: Causas ms frecuentes segn edad y sexo. </li></ul><ul><ul><li>Dficit diettico en nios y ancianos. </li></ul></ul><ul><ul><li>Prdida ginecolgica en mujeres edad frtil. </li></ul></ul><ul><ul><li>Prdida digestiva en varones adultos. </li></ul>< /ul></li><li>ANEMIA FERROPNICA <ul><li>CLINICA </li></ul><ul><li>Anemia propiame nte dicha. </li></ul><ul><li>Carencia hierro: glositis, lengua atrfica, disfagia (Sd Plummer-Vinson), uas frgiles, coiloniquia. </li></ul><ul><li>Proceso subyacent e: Anamnesis </li></ul><ul><li>DIAGNOSTICO </li></ul><ul><li>Parmetros analticos: Hb, Htco, VCM, HCM, ferritina, transferrina, IST, TI C. </li></ul><ul><li>Otros: PEL, sTfR, frotis sangre perifrica, aspirado de mdula sea (tincin de Perls) </li></ ul></li><li>SIGNOS DE ANEMIA FERROPNICA <ul><li>Glositis atrfica Coinoliquia </ li></ul></li><li>ANEMIA FERROPNICA. ESTADIOS <ul><li>Estado de deplecin de depsitos </li></ul><ul><ul><ul><li>Ferritina baja </li></ul></ul></ul><ul><li>Eritropoye sis con deficiencia de hierro. </li></ul><ul><ul><ul><li>Ferritina baja, Hb norm al, TI C, hierro, IST (&lt;16%) </li></ul></ul></ul><ul><ul><ul><li>Froti s SP: microcitosis. VCM, HCM normales. </li></ul></ul></ul><ul><ul><ul><li> PEL , TfR </li></ul></ul></ul><ul><li>Anemia ferropnica establecida. </li></ul><ul> <ul><ul><li> Hb, VCM, plaquetas /N. </li></ul></ul></ul><ul><ul><ul><li>Aspi rado MO: hiperplasia eritroide moderada </li></ul></ul></ul></li><li>ESTUDIO DE ANEMIA FERROPENICA Anemia ferropnica o ferropenia aislada Mujer en edad frtil con sangrado ginecolgico Estudio ginecolgico (H digestiva familiar y personal) SOH Datos digestivos Todos negativos No estudio digestivo Control evolutivo Dat os digestivos Alguno positivo Estudio digestivo Varn &gt;40a Mujeres postmen opasicas Estudio digestivo -Fibrogastroscopia -Colonoscopia -Enema opaco Varn & lt;40a Mujer edad frtil Sin sangrado ginecolgico Individualizar decisin Historia d igestiva familiar y personal SOH Alguna + Estudio digestivo Todos neg Inicialme nte No estudio dig Control evolutivo ANAMNESIS </li><li>ANEMIA FERROPNICA. TRATA MIENTO. <ul><li>Medidas dietticas: fuentes hemnicas mayor biodisponibilidad (30%). </li></ul><ul><li>Suplemento de hierro orales: sulfato ferroso 200mg hierro ele mento/dia. </li></ul><ul><li>Suplementos parenterales de hierro: im, iv. </li></ ul><ul><li>Otros tratamientos alternativos: trasfusin de derivados de sangre. </l i></ul></li><li>CONTENIDO DE HIERRO ELEMENTO COMPUESTOS FERRICOS (III) COMPUES TOS FERROSOS (II) Vial beb 800mg Vial beb 800mg Vial beb 800mg Amp beb 500mg Am p beb 1g Sob 300mg Amp beb 100mg Sob 300mg Sob 300mg Got 125,1mg/ml Comp lib con tr 525mg Grag 256 mg Vial beb 300mg Comp efever 695mg Caps Grag Sol Grag Caps ga st 567,66mg Caps gast 567,66mg Got 170 mg/ml Presentacin 40mg 40mg 40mg Ferplex Ferrocur Lactoferrina Succinilcaseina 56mg 112mg Podertonic Ferrocolinato 40mg 20mg 40mg 40mg Ferroprotina Kilor Profer Ferrimanitol ovoalbumina 25mg/m

    l 106mg 80mg Fer In Sol got Fero Gradumet Tardyferon Sulfato 37.5mg Cromatonbi c Ferro Lactato 80mg Losferron Gluconato 33mg 33mg 16,5mg/5ml Normovite antiane mico Glucoheptato 33g Foliferron Fumarato 100mg cp 100mg cp 30mg/ml Ferbisol , fe rro sanol, glutaferro got Ferroglicina , sulfato Fe elemento(mg) x U Nombre comer cial Compuesto </li><li>Ahora a reponer el hierro </li></ul> </div><!-- .transcript --> <div class="transcriptAd h-below-transcript-ad"> <div class="transcriptAdDiv"><script type="text/javascript"> GA_googleFillSlot("slideview_below_transcript"); </script></div> </div> </div><!-- .assets --> <!-- Footer begins here - Made changes here for the new footer - removed the abo ut section --> <div class="footerWrapper"> <div class="footer"> <div class="footerLeft"> <form class="footerSearch" method="get" action="/search/slideshow"> <fieldset> <input name="searchfrom" type="hidden" value="footer" /> <div class="suggestionContainerFooter"> <input name="q" class="text" id="search_query_bottom" type="text" value="" autoc omplete="off" /><input class="ctaNormal" type="submit" value="Search" /> </div> </fieldset> </form> <!-- .social-links --> <div class="social-links"> <ul> <li><a href="http://www.slideshare.net/mobile" class="iconMobileFooter">SlideSha re <br /> on mobile</a></li> <li><a href="http://twitter.com/SlideShare" class="iconTwitterFooter">Follow us on Twitter</a></li> <li><a href="http://www.facebook.com/slideshare" class="iconFacebookFooter">Find us on Facebook</a></li> <li><a href="http://slidesha.re/SlideShareOnLinkedIn" class="iconLinkedInFooter" >Connect on LinkedIn</a></li> </ul> </div> <!-- /.social-links --> </div> <div class="links footerRight"> <div class="fColumn fColumnSmall"> <ul class="linksList"> <li><strong>Learn About Us</strong></li> <li><a href="/about" title="About us" rel="nofollow">About</a></li> <li><a href="/about/workatslideshare" title="Careers" rel="nofollow">Careers</a> </li> <li><a href="http://blog.slideshare.net" title="Our log">Our log</a></li> <li><a href="/about/press" title="Press" rel="nofollow">Press</a></li> <li><a href="/about/contactus" title="Contact us" rel="nofollow">Contact us</a>< /li> <li><a href="http://help.slideshare.com/home" title="Get Help" rel="nofollow" id ="j-helpLink">Help &amp; Support</a></li> </ul> </div><!-- .fColumn --> <div class="fColumn fColumnMid">

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