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disproportionate to activity level Pallor — particularly of conjunctiva, nail beds, and palmar creases Tachycardia and palpitations — compensatory response to reduced oxygen-carrying capacity Dyspnea on exertion — worsening with progressive anemia Dizziness/lightheadedness/syncope — especially with acute blood loss and volume depletion Hypotension — in acute hemorrhagic cases
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