RELATIONSHIPS BETWEEN RBC INDICES
RBC count
Used to calculate the Hct (Hct = MCV x RBC count)
b. Used by some to predict iron deficiency vs. thalassemia (e.g., Meltzer index)
b. Largely ignored because it says nothing about the size/Hbization of RBCs.
MCV
MCV is super helpful because it is the first branch point in the ddx of anemia - microcytic vs. normocytic vs. macrocytic. Each has its own specific causes.
Hct
The Hct is helpful to a point. As mentioned above it is calculated from the MCV and RBC count. Note that it is impervious to the content of the RBCs.
The only time the Hct is useful is in patients with polycythemia where the negative effects of Hct on blood viscosity (and therefore total peripheral resistance and cardiac output).
MCHC
Think about the MCHC as the degree of central pallor of the RBC - the more central pallor, the lower the MCHC. It is so much more useful than the MCH (which simply tracks with MCV and MCHC), the MCHC is the second branch point in the ddx of anemia.
RBC count
Used to calculate the Hct (Hct = MCV x RBC count)
b. Used by some to predict iron deficiency vs. thalassemia (e.g., Meltzer index)
b. Largely ignored because it says nothing about the size/Hbization of RBCs.
MCV
MCV is super helpful because it is the first branch point in the ddx of anemia - microcytic vs. normocytic vs. macrocytic. Each has its own specific causes.
Hct
The Hct is helpful to a point. As mentioned above it is calculated from the MCV and RBC count. Note that it is impervious to the content of the RBCs.
The only time the Hct is useful is in patients with polycythemia where the negative effects of Hct on blood viscosity (and therefore total peripheral resistance and cardiac output).
MCHC
Think about the MCHC as the degree of central pallor of the RBC - the more central pallor, the lower the MCHC. It is so much more useful than the MCH (which simply tracks with MCV and MCHC), the MCHC is the second branch point in the ddx of anemia.
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THIAMIN (Vit B1) deficiency and refeeding
πΈAlcohol interferes directly with the absorption of thiamine and with the synthesis of thiamine pyrophosphate and it increases urinary excretion.
Thiamine should always be replenished when a
patient with alcoholism is being refed, as carbohydrate repletion without adequate thiamine can precipitate acute thiamine deficiency with lactic acidosis.
Other at-risk populations are women with prolonged hyperemesis gravidarum and anorexia, patients with overall poor nutritional status who are receiving parenteral glucose, patients who have had bariatric/metabolic surgery and patients receiving chronic diuretic therapy.
πΈAlcohol interferes directly with the absorption of thiamine and with the synthesis of thiamine pyrophosphate and it increases urinary excretion.
Thiamine should always be replenished when a
patient with alcoholism is being refed, as carbohydrate repletion without adequate thiamine can precipitate acute thiamine deficiency with lactic acidosis.
Other at-risk populations are women with prolonged hyperemesis gravidarum and anorexia, patients with overall poor nutritional status who are receiving parenteral glucose, patients who have had bariatric/metabolic surgery and patients receiving chronic diuretic therapy.
Papillary Conjunctivitis
Papillary conjunctivitis is an inflammatory condition of the conjunctiva, characterized by the presence of papillae, which are small, raised, red lesions. This condition can be caused by various factors, including allergies, contact lens wear, or prolonged irritation.
Treatment
π Identifying and avoiding allergens or irritants is crucial.
π Oral or topical antihistamines can help control allergic reactions.
π In severe cases, short-term use of steroid eye drops may be necessary.
π Proper cleaning and replacement of contact lenses are essential in managing contact lens-related conjunctivitis.
π Lubricating eye drops can help relieve symptoms and wash away allergens.
Papillary conjunctivitis is an inflammatory condition of the conjunctiva, characterized by the presence of papillae, which are small, raised, red lesions. This condition can be caused by various factors, including allergies, contact lens wear, or prolonged irritation.
Treatment
π Identifying and avoiding allergens or irritants is crucial.
π Oral or topical antihistamines can help control allergic reactions.
π In severe cases, short-term use of steroid eye drops may be necessary.
π Proper cleaning and replacement of contact lenses are essential in managing contact lens-related conjunctivitis.
π Lubricating eye drops can help relieve symptoms and wash away allergens.
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