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SYSTEMATIC APPROACH TO THE EVALUATION OF ANEMIA

The correct diagnosis of anemia can often be determined by combining a thorough history and physical examination with reviews of the complete blood cell count, reticulocyte count, and peripheral blood smear.

History and Physical Examination

Because anemia can be a primary disorder or secondary to other systemic processes, a careful history and physical examination will provide valuable insight into the potential cause. Fatigue often accompanies anemia, but it is very nonspecific and may be related to systemic illness. Nonetheless, determining the concomitant presence of a systemic inflammatory disorder, infection, or malignancy associated with fatigue may be critical in determining the underlying causes of anemia in both adults and children.[25]Past medical history may also be quite informative. For example, a history of diabetes mellitus can be associated with significantly impaired renal production of erythropoietin even in the setting of …