Sandbox:Abdulkareem

# CORONARY ARTERY DISEASE
coronary artery disease are diseases characterized by narrowing or thickening of the coronary vessels leading to decrease oxygen supply to the heart.

## Anatomy of the coronary arteries
the heart has the following 

# ANEMIA

## Definition
anemia affects a third of the worlds population
anemia is a condition characterized by a decrease in oxygen carrying capacity of the blood due to a decrease in hemoglobin level.this further leads to decrease oxygen supply to major organs thus leading to a decrease in physiologic activity of the organ.

## symptoms of Anemia
the symptoms of anemia depends on the hemoglobin level.
- Men - 13.75g/dl-17.5g/dl
- Women- 12.0-15.5g/dl
hemoglobin level greater than 10g/dl is usually asymptomatic
- hemogobin 8g/dl- 9g/dl- malaise , fatigue , headache
- hemoglobin 6g/dl-7g/dl-dyspnea on exertion , presyncope
- hemoglobin 4g/dl-5g/dl- myocardial infarction , stroke, high output cardiac failure.

### types of Anemia
anemia can be classified in different ways , but the best and easiest way to classify anemia is by using the mean corpuscular volume(MCV).normal MCV is 80%- 100%,
- MCV < 80%- Microcytic anemia
- MCV- 80%-100%- normocytic anemia
- MCV> 100%- Macrocytic anemia.

## Microcytic Anemia
Microcytic anemia are generally production anemia , it is usually caused by a decrease or absent of factors that are needed for the formation of hemoglobin. hemoglobin as an entity is made up of heme and globin. heme is further broken down into iron and protopophyrin. an understanding of all these components gives a proper understanding of microcytic anemias , we can then classify them into 4.
- Iron Deficiency Anemia
- Thalassemia
- Anemia of Chronic disease
- Sideroblastic Anemia

### Macrocytic Anemia
macrocytic anemia generally is a usually due to a defect in DNA synthesis of RBCs, The initial test needed to classify macrocytic anemia is usually the blood smear. blood smear showing hypersegmented neutrophils(>5 lobes of neutrophils). if hypersegmented neutrophils is positive then its most likely caused by megaloblastic macrocytic anemia , and negative hypersegmented neutrophils is a pointer to non megaloblastic macrocytic anemia.
-  Anker, Stefan D; Hess, Sibylle; Asbrand, Christian; Jung, Hyejung; Ried, Janina; Gerstein, Hertzel C; Doehner, Wolfram (2020). "Obesity and weight loss are inversely related to mortality and cardiovascular outcome in prediabetes and type 2 diabetes: data from the ORIGIN trial". European Heart Journal. doi:10.1093/eurheartj/ehaa293. ISSN 0195-668X..mw-parser-output cite.citation{font-style:inherit}.mw-parser-output q{quotes:"\"""\"""'""'"}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-lock-free a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-limited a,.mw-parser-output .cs1-lock-registration a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-subscription a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{display:none;font-size:100%}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}