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PHM 703- Oncology, Hematology > Anemia > Flashcards

Anemia Flashcards

1
Q

Microcytic anemia definition

A

<80 fL

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2
Q

Causes of microcytic anemia

A

IDA

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3
Q

IDA causes

A

Blood loss, iron malabsorption

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4
Q

Significant finding for IDA in iron panel

A

Serum ferritin and MCV are decreased

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5
Q

IDA treatment

A

Diet: increase intake of foods high in iron (8mg/day for adult males and postmenopausal females, 18mg for menstruating females)

Iron supplementation

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6
Q

Iron supplementation products

A

Ferrous sulfate
Ferrous gluconate
Ferrous fumarate

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7
Q

Iron supplementation dosing frequency

A

QOD with ascorbic acid to increase PO absorption

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8
Q

PO iron/DDIs: drugs that decrease iron absorption

A

Al/Mg/Ca-containing antacids
TTCs, doxycycline
H2RAs
PPIs
Cholestyramine

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9
Q

PO iron DDIs: drugs decreased by iron

A

Levodopa
Methyldopa
Levothyroxine
Pencillamines
FQs
TTC, doxycycline
MMF

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10
Q

Indications for IV iron therapy

A

Malabsorption
Poor oral adherence or tolerance
Gastric Bypass
Chronic Kidney Disease
Cancer while receiving active chemotherapy

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11
Q

IV iron drugs available

A

Iron sucrose
sodium ferric gluconate
ferric carboxymaltose
iron dextran
ferumoxtyol

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12
Q

ADEs of IV iron

A

Cramping
Flushing
Hypotension
Nausea
Vomiting
GI irritation
Rash
Malaise
Arthralgias
Myalgias
Hypophosphatemia
Infection??

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13
Q

ADEs of PO iron

A

Dark, discolored feces
Constipation
Nausea
Vomiting

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14
Q

Typical IV iron dosing

A

Iron sucrose 200mg IV x5 days

Decrease dose by 1 day’s worth if previously received pRBC transfusions

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15
Q

Macrocytic anemia definition

A

> 100 fL

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16
Q

Causes of macrocytic anemia

A

Folic Acid Deficiency
Vitamin B12 Deficiency
Liver Disease
Alcohol
Hypothyroidism
Drugs (Sulfonamides, Antineoplastics)

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17
Q

Causes of Vitamin B12 deficiency

A

Inadequate intake from diet, malabsorption syndrome

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18
Q

Significant findings for Vitamin B12 deficiency on iron panel

A

Serum folate unchanged
MMA and homocysteine is increased

19
Q

Vitamin B12 deficiency anemia treatment

A

Vitamin B12 supplementation PO or IM/SQ, dietary intake

20
Q

PO vitamin B12 dosing

A

1000-2000mcg QD

21
Q

IM/SQ vitamin B12 dosing

A

1000mcg QD x1 week, then 1000mcg qweek x4 weeks, then 1000mch qmonth

22
Q

Vitamin B12 side effects

A

Hyperuricemia, hypokalemia

23
Q

Suggested dietary intake of vitamin B12

A

0.4mcg/day

24
Q

Folate deficiency anemia causes

A

Inadequate intake, decreased absorption, increased folate requirements (so you’re not getting enough)

25
Q

Folate deficiency findings on iron panel

A

Decreased folate, UNCHANGED MMA, increased homocysteine

26
Q

Folate deficiency anemia treatment

A

PO supplementation

27
Q

Folic acid in most patients

A

1mg PO QD

28
Q

Folic acid in pregnancy

A

4mg PO QD

29
Q

Folic acid AEs

A

Well-tolerated, could have flushing, malaise, pruritus/rash

30
Q

Normocytic anemia definition

A

80-100 fL

31
Q

Causes of normocytic anemia

A

Aplastic Anemia
Anemia of Chronic Disease
Chronic Kidney Disease (CKD)
Hemolytic Anemia

32
Q

Significant finding for AI on iron panel

A

Decreased TIBC (will separate it from IDA)

33
Q

AI treatment

A

Treatment of underlying condition causing chronic inflammation
ESAs
pRBC transfusions

34
Q

ESAs in AI

A

Epoetin alfa, darbepoetin alfa

35
Q

Epoetin alfa AEs

A

fever, N/V, hypertension, cough, pruritus, rash, headache, arthralgias

36
Q

Darbepoetin alfa AEs

A

infections, blood pressure alternations, headache, nausea/vomiting, diarrhea, peripheral edema

37
Q

Half-life of epoetin alfa

A

9 hours

38
Q

Half-life of darbepoetin alfa

A

25 hours

39
Q

ESA treatment is only effective when what?

A

Bone marrow has adequate stores of iron, B12, and folate

40
Q

ESAs: when to D/C

A

Hgb >12g/dl

41
Q

ESAs: when to hold or decrease dose

A

Hgb >1g/dl in 2 weeks

42
Q

AI treatment in patients with malignancy

A

Determine underlying cause and treat it
Iron supplementation

43
Q

When to consider pRBCs in AI treatment

A

acute oxygenation complications or Hgb <7g/dl

PHM 703- Oncology, Hematology (15 decks)

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