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House Pharmacology > Anaemia And Drug Treatment > Flashcards

Anaemia And Drug Treatment Flashcards

1
Q

Key components of hematologic system are:
•Blood
•Blood forming tissues
__________
_______
______ system

A

Bone marrow

Spleen

Lymph

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2
Q

The main components of the haemopoietic system are the
_______
________
_________ and _______

______,_______, and _______ are important accessory organs.

A

blood,
bone marrow,
lymph nodes and thymus

spleen, liver and kidneys

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3
Q

Erythrocytes/Red Blood Cells

•Composed of _________

•Erythropoiesis
 Stimulated by______
 Controlled by _______
Hormone synthesized in ______

A

hemoglobin

hypoxia; erythropoietin

kidney

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4
Q

Erythrocytes/Red Blood Cells

Hemolysis

Releases _______ into blood stream

Normal lifespan of RBC = ________

A

bilirubin

120 days

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5
Q

White blood cells

___ types

List them

A

5 types
Basophils Eosinophils Neutrophils Monocytes Lymphocytes

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6
Q

Types and Functions of Leukocytes

Granulocytes

Neutrophil : _______, _____ phase of ______

Eosinophil : ________, _______ infections

Basophil: _________ response , _____ response

A

Phagocytosis, early phase of inflammation
Phagocytosis, parasitic infections
Inflammatory response, allergic response

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7
Q

Types and Functions of Leukocytes

Agranulocytes

Lymphocyte : ______,_______ immune response

Monocyte: __________, _______ immune response

A

Cellular, humoral immune response

Phagocytosis; cellular immune response

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8
Q

Thrombocytes/Platelets
Must be present for ______ to occur

Involved in ________

A

clotting

hemostasis

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9
Q

Normal Clotting Mechanisms: Hemostasis

Goal: ________________ when injured

A

Minimizing blood loss

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10
Q

Normal Clotting Mechanisms: Hemostasis

Vascular Response
______________

Platelet response
Activated during injury to Form ______ (________)

Plasma Clotting Factors
Factors I – XIII
__________
__________

A

vasoconstriction

clumps; agglutination

Intrinsic pathway

Extrinsic pathway

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11
Q

Liver

Receives ____% of the cardiac output (_____ ml of blood each minute)

A

24

1500

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12
Q

Liver

Liver has many functions Hematologic functions:
Liver synthesizes plasma proteins including _______ and ______

Liver clears _______ and _________ from circulation

A

clotting factors and albumin

damaged and non- functioning RBCs/erythrocytes

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13
Q

Spleen
Located in _________ of abdomen

A

upper L quadrant

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14
Q

Spleen

Functions
Hematopoietic function
 Produces ______

Filter function
 ______ and ______ certain cells

A

fetal RBCs

Filter and reuse

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15
Q

Spleen

Functions

Immune function
________,________

Storage function
____% platelets stored in spleen

A

Lymphocytes, monocytes

30

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16
Q

Diagnostic Studies of the Hematologic System: Complete Blood Count (CBC)

WBCs
Normal = ______-______ μ/l

RBC
♂ ____-_____ x 106/l
♀ _____-_____ x 106/l

A

4,000 -11,000

4.5 – 5.5

4.0 – 5.0

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17
Q

Hematocrit (Hct)
The hematocrit is the percent of ______ that is composed of _______.

A

whole blood

red blood cells

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18
Q

The hematocrit is a measure of both the ______________ and ____________

A

number of red blood cells and the size of red blood cells.

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19
Q

Diagnostic Studies of the Hematologic System: Complete Blood Count (CBC)

Platelet count
Normal = ________ -________

A

150,000- 400,000

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20
Q

Spontaneous hemorrhage likely when count is below ______

A

20,000

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21
Q

Pancytopenia
 ______ease in number of _______________________________________

A

Decr

RBCs, WBCs, and platelets

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22
Q

Anemia is a reduction in _____________,___________ or __________

A

the number of RBCs, the concentration of hemoglobin, or the volume of RBCs

23
Q

Because the main function of RBCs is __________, anemia results in varying degrees of ______

A

oxygenation

hypoxia

24
Q

Anemia: Prevalent conditions

___________
________ ————- of erythrocytes
________ ————- of erythrocytes

A

Blood loss

Decreased production

Increased destruction

25
Q

Anemia
Clinical Manifestations:
1._____.
2. ______,_______
3._______.
4. Palpitations, _____cardia.
5. Headache, dizziness, and restlessness. 6. ______ of thought.
7. ________.
8. _____________ (chronic)

A

Pallor

Fatigue, weakness.

Dyspnea

Tachy

Slowing

Paresthesia

Asymptomatic

26
Q

Different types of anaemia

hypochromic, microcytic anaemia (____ sized red cells with ____ haemoglobin; caused by __________)

macrocytic anaemia (____ sized red cells,____ in number)

normochromic normocytic anaemia (_____ in number , ______-sized red cells, each with a _______ haemoglobin content)
mixed pictures.

A

small; low; iron deficiency

large; few

fewer; normal; normal

27
Q

Anemia Caused by Decreased Erythrocyte Production

_____ Deficiency Anemia
_________ Anemia
___________

A

Iron

Megaloblastic

Thalassemia

28
Q

More precise diagnostic groupings of anaemias

deficiency of nutrients necessary for haemopoiesis, most importantly:

_______
___________ and ___________
______,__________

A

iron

folic acid and vitamin B12

pyridoxine, vitamin C.

29
Q

Important to note

Use of haematinic agents is often only __________ to treatment of the underlying cause of the anaemia

________ for colon cancer

_____________ for hookworm

Withdrawing NSAIDs is used to reduce GI _________

A

an adjunct

Surgery

Antihelminthics

blood loss

30
Q

Iron-Deficiency Anemia

Etiology
•Inadequate dietary intake
Found in _____% of the world’s population

•Malabsorption
Absorbed in ______
GI surgery

•Blood loss
___ mls blood contain __ mg iron
GI losses

•__________

A

30

duodenum

2; 1

Hemolysis

31
Q

Iron-Deficiency Anemia: Clinical Manifestations

Most common: _______
Second most common: __________ of _____________(________)

___________

Sensitivity to _____
Weakness and fatigue

A

pallor

inflammation of the tongue (glossitis)

Cheilitis; cold

32
Q

Cheilitis= ________/________ of _____

A

inflammation/fissures of lips

33
Q

Diagnostic Studies

CBC
Iron studies Diagnostics:
Iron levels: ___________ (TIBC), Serum ________.

A

Total iron-binding capacity

Ferritin

34
Q

Iron-Deficiency Anemia

Collaborative Care
Treatment of __________/problem
__________
Diet
_______

A

underlying disease

Replacing iron

Drug Therapy

35
Q

Iron-Deficiency Anemia

Drug Therapy

•Iron replacement

-Oral iron
_____ ,________ etc
Absorbed best in ______ environment

•Parenteral iron
IM or IV
(More or Less?) desirable than PO

A

Fesulf, Fergon; acidic

Less

36
Q

Drug Interactions with Fe

Antacids
Colestyramine
Neomycin
Quinolones
Tetracyclines
Levodopa
carbidopa
levothyroxine

A

Moveeeeeee

37
Q

Megaloblastic Anemias

Characterized by (small or large ?) RBCs which are _____ and easily _______

A

Large

fragile; destroyed

38
Q

Common forms of megaloblastic anemia

__________ deficiency

___________ deficiency

A

Cobalamin

Folic acid

39
Q

Cobalamin (Vitamin B12) Deficiency

Cobalamin Deficiency–formerly known as _______ anemia

A

pernicious

40
Q

Cobalamin (Vitamin B12) Deficiency

____________ is required for cobalamin absorption

A

Intrinsic factor (IF)

41
Q

Causes of cobalamin deficiency

Gastric mucosa ____________

GI surgery leads to _____________________

Long-term use of _______________ cause atrophy or loss of gastric mucosa.

__________ deficiency

Hereditary defects of cobalamine utilization

A

not secreting IF

loss of IF-secreting gastric mucosal cells

H2-histamine receptor blockers

Nutritional

42
Q

Cobalamin Deficiency
Diagnostic Studies

Schilling Test: a medical investigation used for patients with vitamin B12 deficiency. The purpose of the test is to determine if _________________________

A

the patient has pernicious anemia.

43
Q

Cobalamin Deficiency
Collaborative Care

__________ administration of cobalamin

______cobalamin does not correct the anemia

(High or Low ?) dose oral cobalamin can be used
Drug int: H2 receptor antagonists reduce its absorption

A

Parenteral

↑ Dietary

High

44
Q

Folic Acid Deficiency

Folic Acid Deficiency also causes ________ anemia
Folic Acid required for RBC formation and maturation

A

megaloblastic

45
Q

Folic Acid Deficiency

Causes
Poor_________
Malabsorption syndromes
Drugs that inhibit absorption
_______ abuse
Hemodialysis

A

dietary intake

Alcohol

46
Q

Folic Acid Deficiency

Clinical manifestations are similar to those of ________ deficiency

Insidious onset: progress (slowly or rapidly?)

(Presence or Absence?) of neurologic problems

Treated by ________ therapy

Encourage patient to eat foods with large amounts of folic acid

A

cobalamin

Slowly ; Absence

folate replacement

47
Q

Drug Interactions with Folic Acid

________ impaired (seizure control)
_______
____________,_________
MMT
Sulphasalazine

A

Phenytoin

Phenobarbitone

Co trimoxazole, trimethoprim

48
Q

Thalassemia
Etiology

_____________________ genetic disorder of _________________ of normal hemoglobin
Found in Mediterranean ethnic groups

A

Autosomal recessive

inadequate production

49
Q

Thalassemia

Clinical Manifestations
________ then major _______ then life threatening

________,_________

A

Asymptomatic

retardation

Splenomegaly, hepatomegaly

50
Q

Thalassemia
Collaborative Care

________ drug or diet are effective in treating thalassemia

Thalassemia minor
____________________

Thalassemia major
___________ with ________ (used to remove excess iron from the body)

A

No specific

Body adapts to ↓ Hgb

Blood transfusions with IV deferoxamine

51
Q

Thalassemia
Collaborative Care
No specific drug or diet are effective in treating thalassemia
Thalassemia minor
Body adapts to ↓ Hgb Thalassemia major
Blood transfusions with IV deferoxamine (used to remove excess iron from the body)

A
52
Q

Anemia of Chronic Disease

____________ of RBCs, _________[ of RBC survival

Generally develops after ____________ of sustained disease

A

Underproduction

shortening

1-2 months

53
Q

___________ is 2nd most common cause of anemia after _______________ anemia

A

Anemia of Chronic Disease

iron deficiency

54
Q

Aplastic Anemia: Treatment

Blood transfusions
Antibiotics
Immunosuppressants  __________

Bone marrow stimulants  _________, _________
Bone marrow transplantation

A

Corticosteroids

Filgrastim, Epoetin alfa

House Pharmacology (50 decks)

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