22. Agents Used in Anemia

Question 1

A 28 year old pregnant women comes to here doctor for a check up. She is mildly tachycardic with pale mucous membranes. Numerous hypopigmented macules are noted on her arms. There are no neurological defects what would you expect from her lab results?

A. Normal homocysteine 
B. Normal Methylmalonate 
C. Increased Methylmalonate 
D. Decreased Methylmalonate 
E. Normal Methmalony-CoA 

RFA

Answer 1

Ans. B- Normal Methylmalonate- The patient has Folate deficiency she is pregnant which need increased folate so is at risk and has the symptoms of B12 or Folate deficiency but with no neuro symptoms which differentiates Folate deficiency.

Folate deficiency- increased Homocysteine, normal Methylmalonate

B12- Increased Homocysteine, Increased Methylmalonate, increase Methylmalonyl-CoA

Question 2

A 2 year old child is rushed to the hospital with symptoms of vomiting of diarrhea of black stool. His mother believes he ate some of her medications. An X-ray used showing radio-opaque pills in the GI tract. The radiologist tells you she believes the pills were ingested over 3 hours ago. What is the correct treatment for the child.

A.Deferasirox 
B Hydroxyurea 
C. Metformin 
D. Filgrastim 
E. Deferoxamine 

RFA

Answer 2

Ans. E. Deferoxamine- the child has iron toxicity: black stool and diarrhea and confirmed by the radio-opaque pill on x-ray. Deferoxamine is an iron chelator given VIA that promotes iron excretion in urine and feces

A. Deferasirox- is a oral iron chelator and is given as a outpatient medication and is only effective in reducing iron absorption if given within an hour of ingestion

B. Hydroxyurea - is given to SCD and B-thalassemia patient to increase HBF

C. Metformin- is a drug used for type diabetes it can cause B12 Deficiency

D. Filgrastim- is given to chemo patients to increase neutrophil production and function.