Anemia Flashcards
How is anemia defined in males?
Hemoglobin <13.6 or hematocrit <40%
How is anemia defined in females?
Hemoglobin <11.9 or hematocrit <35%
Which MCV describes microcytic?
<80
Which MCV described macrocytic?
> 100
What does a low retic count mean in anemia?
Impaired RBC production (inflammation, renal disease, B12 deficiency)
What does a high retic count mean in anemia?
Acute blood loss or hemolysis
What causes macrocytic anemia?
B12 or folate deficiency (blood cells do not mature and condense)
What does a high MMA indicate?
B12 deficiency
What does a high homocysteine indicate?
B12 or folate deficiency
What does B12 deficiency present like?
- Cognitive impairment
- Peripheral neuropathy
- Gait abnormalities
What causes microcytic anemia?
- Iron deficiency*
- Sickle cell
- Thalassemia
What additional labs should we look at when working up microcytic anemia?
- Ferritin*
- Transferrin saturation (TSAT) <16%
How do we treat iron deficiency anemia?
100-200 mg oral elemental iron without food
What can enhance absorption of oral iron?
Vitamin C
When do we use parenteral iron?
- CKD
- Hemodialysis
- Unable to tolerate oral or failed
- Patient refused blood transfusions
Which IV iron requires a testing dose?
Iron dextran complex (reaction risk)
What causes normocytic anemia?
EPO deficiency (CKD)
Which IV iron should be avoided in pregnancy and babies?
Ferrlecit
When do we give iron therapy in CKD?
TSAT <30%
Ferritin <500
What are the BBW of ESAs?
Increased risk of death, stroke, MI, VTE
When do we initiate ESAs?
Hgb < 10
