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may progress to hemorrhagic shock Tachypnea compensatory respiratory response Decreased urine output in hypovolemic states from acute blood loss Koilonychia (spoon nails) and glossitis classic signs of chronic iron deficiency anemia Pica craving for non-food items (ice, clay, dirt) seen in severe iron deficiency Polycythemia Pruritus after bathing (aquagenic pruritus) characteristic of polycythemia vera

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It often causes pain, stiffness, swelling, and reduced function, especially in the shoulders, elbows, wrists, knees, or Achilles tendon