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1.HIV

2.Hepatitis B and C

3.Beta thalassemia major

4.Secondary infection

5.Sickle cell disease

6. Anaemia

Futher examination

1. Full blood count

2. Family history - thalassemia patient

3. Ask about Blood transfusion program

4. Iron chelation therapy

5. Check about his siblings symptoms (carriers)

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Trigger 1

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jaundice - condition which the skin and whites of the eyes become yellow - haemolytic jaundice

tachychardia - abnormal heart rate

hepatosplenomegaly - enlargement of liver and spleen

hypochromia - rbc have less colour than normal

microcytosis - smaller than normal size

reticulocytosis - high amount of reticulocytes

polychromasia - multicoloured rbc in blood

target cells - presence of stain at the central pallor of rbc

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Pretansfusion test - test before blood transfuse utk compatibilitu

Anti-duffy ab - antigen dekat surface RBC, human blood group system. Anti-duffy ab will attack duffy dekat RBC

iron chelation therapy - guna drug to remove of excess iron from the body. ( supplement folic acid). Increase secrete of harmful antigen to remove. Start after serum firitin reach level or after 12-14 transfussion. ( can do oral, subcutaneous)

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bone marrow examination -

complete blood count ( as shown )

ultrasound- for hepatosplenomegaly

genetic testing

hb electrophoresis

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10 year old boy - immune system still developing , prone to get infection

Scheduled blood transfusion program - due to severe ineffective erythropoiesis and can cause iron overload

Pallor - lack of O2 and hemoglobin

Loss of appetite - lack of nutrients

Abdominal distention - refer to spleen enlargement

Shortness of breath - dyspenia

Occasionally hospitalised - secondary cause effect from blood transfusion

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regular blood transfusion - maintain Hb level & suppress abnormal thalasemia erythropoiesis

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Abdominal distention - swollen abnormally (bloating from gas) in digestive

Pallor - look pale on person skin

Homozygous - 2 identical alleles of particular gene

Beta thalassemia major - genetic disorder of deficiency beta hemoglobin that cause anaemia

Splenomegaly - spleen enlargement cause spleen overwork

Blood transfusion - transfer of blood from one person to another

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blood transfusion - every 4 weeks , using wash filter blood to remove white blood cell and plasma protein ( avoid effect)

BM transplantation - best managment for thalasemmia

Gene therapy

Splenactomy - for spleenomegaly - should not be done befor 5 years of live

Folic acid treatment - proliferation and maturation of RBC

B - thalasemmia prevention

thalasemmia test before marriage

screening at school level

prenatur during pregnancy before deliver

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low hb - severe anemia - < 100g/L

low hematocrit -

low MCV

low MCH

MCHC

hypochromic micrositic ( if mhv, mhc, and mchc is low )

rdw - normal

slightly increase wbc count - to know if there’s infection

high platelet count (thrombocytosis)- indicate bleeding tendency - due to increase microcytes - counted as platelet

serum ferritin - normal - patient not having iron deficiency

folate - normal - not haeAnemia

Hb-A , HbA2, Hb-F - to count hb variant - for thalassemia type determination

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Trigger 2