All right, so we're going to do an internal medicine update. And the first thing I want to do

is shout out to a listener, Chris King, a hospice in Scottsdale, Arizona. He sent me an email,

actually a while back. I think this is from May of 2016. But one thing I love about my listeners

is that they listen very, very closely, which is something you just have to do

when you're talking medicine. And he caught me. Chris King, good job. You noticed in my iron

deficiency anemia lecture that I misspoke about RDW. I don't know what I was thinking. I listened

back to that and I was going

pretty fast and I think I said this in under a second, but I said the RDW in iron deficiency

anemia is decreased, which is crazy. It's increased. The RDW is the red blood cell distribution

width. And basically it tells you, is there a variation? RDW is the red blood cell distribution with.

And basically, it tells you, is there a variation

in the size of the red blood cells that is on the smear?

Or is there no variation?

And when you're dealing with deficiencies of vitamin

or minerals, in this case, I was talking about iron, but actually with

folate, vitamin B12, and iron, there often is an increase in the RDW. I mean, there's an increase

in the distribution of sizes of the red blood cells that you will see. And while RDW is not specific enough to give you a diagnosis

of the type of anemia that you're looking at, nevertheless, it can be just one of those pieces of

information that you put together. But it is not decreased in iron deficiency anemia. It is often increased,

sometimes normal. And actually, I'm not aware of a condition where an RDW is less than normal.

So any bright listeners out there that are really into hematology, if there is a hematologic

condition that causes a low RDW, let me know what that is, but I'm not aware

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