Chart — Hematology
Anemia Type Comparison Chart
Start with cell size (MCV), confirm with the second lab — ferritin for small cells, B12/folate for large ones, reticulocytes for normal-sized — and the type, treatment, and teaching follow.
Educational use only. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Anemias Side by Side
| Type | Cell Size | Key Labs | Common Causes | Treatment | Nursing Notes |
|---|---|---|---|---|---|
| Iron deficiency | Microcytic (↓MCV) | ↓Ferritin, ↓iron, ↑TIBC | Blood loss (GI, menstrual), poor intake, malabsorption | Oral or IV iron; find and fix the bleeding source | Iron on empty stomach with vitamin C; dark stools expected; constipation management; GI source workup in adults |
| B12 deficiency | Macrocytic (↑MCV) | ↓B12; intrinsic-factor antibodies in pernicious anemia | Pernicious anemia, gastric surgery, strict vegan intake, ileal disease | Parenteral or high-dose B12 — lifelong in pernicious anemia | Neuro findings (paresthesias, balance, cognition) are the differentiator; damage becomes permanent if untreated |
| Folate deficiency | Macrocytic (↑MCV) | ↓Folate, normal B12 | Poor intake, alcohol use disorder, pregnancy demand, some drugs | Oral folate; dietary repletion | No neuro findings; critical pre-conception and first trimester (neural tube defects) |
| Aplastic | Normocytic | Pancytopenia — ↓RBC, ↓WBC, ↓platelets; ↓retics | Marrow failure — idiopathic, drugs, chemicals, radiation, viral | Immunosuppression, transplant candidacy, transfusion support | Infection precautions + bleeding precautions simultaneously; this is a protective-care diagnosis |
| Hemolytic | Normocytic | ↑Retics, ↑LDH, ↑indirect bilirubin, ↓haptoglobin | Autoimmune, drug-induced, mechanical (valves), sickle cell, transfusion reaction | Treat the cause; steroids for autoimmune; transfusion support per provider | Jaundice and dark urine; marrow compensating (high retics) while cells die early |
| Chronic disease | Normocytic (sometimes microcytic) | Normal/↑ferritin, ↓iron, ↓TIBC | Chronic inflammation — CKD, autoimmune disease, malignancy | Treat the underlying disease; erythropoiesis-stimulating agents in CKD per protocol | Iron supplements alone do not fix it — ferritin pattern separates it from iron deficiency |
Two-Lab Shortcuts
• Microcytic + low ferritin = iron deficiency · microcytic + normal/high ferritin = chronic disease
• Macrocytic + neuro symptoms = B12 · macrocytic without = folate
• Normocytic + high retics = loss or hemolysis · + low retics = underproduction
• All three cell lines down = aplastic — switch to protective care
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with AABB (transfusion standards) · American Society of Hematology (ASH). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →