Anemia

Question 1

Anemia:

Anemia is characterized by insufficient red blood cells or hemoglobin to meet the body’s needs.

Answer 1

Symptoms progress in severity and can include fatigue, pallor, palpitations, shortness of breath, and even unconsciousness if left untreated.

Question 2

Early Signs:** Decreased energy, fatigue, poor appetite, headaches.

Answer 2

anemia

Question 3

Advanced Signs Pallor, flow murmur, orthostasis, baseline tachycardia, hypotension, unresponsiveness.

Answer 3

anemia

Question 4

Dietary Factors:

Answer 4

PICA (often related to iron deficiency), high cow’s milk diet (can lead to iron deficiency), and goat’s milk diet (can lead to folate deficiency).

Question 5

Physiologic Nadir:** Occurs in infants 8-12 weeks old due to transition from fetal to adult hemoglobin.

Question 6

Nutritional Factors

Answer 6

iron, B12, or folate deficiencies might present with symptoms.

Question 7

Diagnostic Approach:

Answer 7

Labs to Check:** Mean Corpuscular Volume (MCV) and Red Cell Distribution Width (RDW) are critical for categorizing anemia

Question 8

Reticulocyte Count

Answer 8

Indicates the bone marrow’s response. A low count suggests decreased production, while a high count suggests a response to increased red cell destruction.

Question 9

Microcytic Anemia

Answer 9

(MCV < 70):** Often due to iron deficiency or lead poisoning.

Question 10

Normocytic Anemia:

Answer 10

Could result from acute blood loss or anemia of chronic disease.

Question 11

Macrocytic Anemia

Answer 11

(MCV > 85):** Usually due to B12 or folate deficiency.

Question 12

Red Cell Distribution Width (RDW):

Answer 12

Measures variation in red blood cell size. A high RDW can indicate a mixed anemia, with some cells large and others small, like in simultaneous iron and folate deficiencies.

Question 13

Low Reticulocyte Count

Answer 13

Suggests failure to produce red blood cells due to recent blood loss or decreased production.

Question 14

High Reticulocyte Count

Answer 14

Indicates the bone marrow is active, often seen in hemolytic anemias or chronic bleeding conditions.

Question 15

Which of the following is an early symptom of anemia?
A) Unconsciousness
B) Headache
C) Orthostatic hypotension
D) Baseline tachycardia

Answer 15

Answer:** B) Headache

Question 16

A 10-week-old infant is found to have low hemoglobin levels on routine screening. The FNP recognizes this as:A) Iron deficiency anemia
B) Physiologic nadir
C) Thalassemia
D) Lead poisoning

Answer 16

Answer: B) Physiologic nadir

Question 17

In microcytic anemia (MCV <70), which of the following is a common cause?
A) B12 deficiency
B) Iron deficiency
C) Folate deficiency
D) Chronic liver disease

Answer 17

Answer: B) Iron deficiency

Question 18

A patient presents with pallor, increased heart rate, and fatigue, and their labs show a high RDW and normal MCV. This suggests:
A) Mixed anemia with both iron and folate deficiency
B) Macrocytic anemia
C) Normocytic anemia
D) Acute blood loss

Answer 18

*Answer:** A) Mixed anemia with both iron and folate deficiency

Question 19

Which lab test would you order to evaluate the bone marrow’s response to anemia?
A) Serum ferritin
B) Mean Corpuscular Hemoglobin Concentration (MCHC)
C) Reticulocyte count
D) Hematocrit

Answer 19

*Answer:** C) Reticulocyte count

Question 20

A patient with a chronic autoimmune hemolytic anemia may present with which type of reticulocyte count?
A) Low
B) Normal
C) High
D) Zero

Answer 20

Answer: C) High

Question 21

An FNP is assessing a child with lead exposure who has developed anemia. Which type of anemia is most likely?
A) Normocytic anemia
B) Macrocytic anemia
C) Microcytic anemia
D) Sideroblastic anemia

Answer 21

Answer: C) Microcytic anemia

Question 22

A vegan patient presents with fatigue and “tingling” sensations in their hands and feet. Their MCV is elevated. Which deficiency should be suspected?
A) Iron deficiency
B) Vitamin B12 deficiency
C) Folate deficiency
D) Vitamin D deficiency

Answer 22

*Answer:** B) Vitamin B12 deficiency