Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHRM 864 > Anemia > Flashcards

Anemia Flashcards

1
Q

What is anemia?

A

decrease in RBC or hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs/Symptoms of Anemia

A
  • exertional dyspnea
  • angina
  • tachycardia
  • fatigue
  • Pallor

may be asymptomatic if develops slowly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Normal RBC

A

4.5-5.5 x 10^6 cells/uL –> male

4.1-4.9 x 10^6 cells/uL –> female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Normal Hemoglobin

A

13.5-18 g/dL –> male

12-16 g/dL –> female

oxygen carrying capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Diagnosis

A

Hb < 13.5 g/dL –> male

Hb < 12 g/dL –> female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Normal Mean Corpuscular Volume (MCV)

A

80-100 mm^3

average volume of RBC (size)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Normal RBC Distribution Width (RDW)

A

11.5-14.5%

variation in size of RBCs (range)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Normal Ferritin

A

15-200 ng/mL

acute phase reactant –> elevated in acute inflammation or chronic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Diagnostic Ferritin

A

< 45 ng/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Normal TSAT

A

20-50%

amount of iron ready for erythropoiesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Diagnostic TSAT

A

< 20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diagnostic B12

A

< 200 pg/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diagnostic Folate

A

< 5 ng/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Causes of Anemia

A

Decreased RBC production
- Chronic diseases: CKD, cancer, CHF
- Nutritional deficiencies: iron, folic acid, vitamin B12

Increased RBC destruction
- drugs
- sickle cell anemia/thalassemia

Increase RBC loss
- acute blood loss
- NSAIDs, ASA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Microcytic

A

MCV < 80

iron deficiency
sickle cell anemia
thalassemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Normocytic

A

MCV 80-100

anemia of chronic disease
blood loss
hemolysis

16
Q

Macrocytic

A

MCV > 100

folic acid deficiency
B12 deficiency

17
Q

Consequences of Anemia

A
  • impaired cognitive function
  • falls
  • heart failure
  • A-fib
  • CV events
18
Q

Iron Deficiency Anemia

A

Bloodwork
- decreased Hb
- decreased MCV
- normal/increased RDW
- increased TIBC/transferrin
- normal/decreased serum iron
- decreased TSAT

Causes:
- blood loss: menstruation, blood donation
- decreased absorption of iron
** celiac disease
** malabsorptive state
- vegetarian diet
** heme (meat)
** non-heme (plants, diary) –> not absorbed well
- increased consumption –> pregnancy

Side effects:
- spoon-shaped nails (koilonychias)
- inflamed tongue (glossitis)
- pica
** pagophagia –> ice
** geophagia –> dirt, soil, clay

19
Q

Treatment of Iron-Deficiency Anemia

A

ORAL IS PREFERRED

Oral Dose:
- 65 mg of elemental iron every other day

Exceptions favoring IV:
- cannot tolerate
- cannot absorb
- ESKD
- heart failure

Repletion:
- 3 to 6 months

20
Q

Hepcidin

A
  • iron regulating peptide hormone produced in liver
  • decreases dietary iron absorption and iron transfer to the plasma
  • increased after a dose of oral iron for approx. 24 hours and normalizes within 48 hours
21
Q

Elemental Iron

A

Ferrous fumarate
- tablet strength: 300 mg
- elemental: 100 mg

Ferrous sulfate
- tablet strength: 325 mg
- elemental: 65 mg

Ferrous gluconate
- tablet strength: 300 mg
- elemental: 30 mg

22
Q

Counseling Points of Iron

A
  • increased absorption on empty stomach
  • causes stomach upset –> may take with food
  • absorption increased by ascorbic acid (vitamin C)
  • causes constipation
  • causes dark stools
23
Q

Side Effects of IV Iron

A

hypotension during infusion

skin tattooing

24
Q

Vitamin B12 Defiency Anemia

A

Bloodwork
- decreased Hb
- increased MCV
- increased RDW
- decreased serum B12
- increased homocysteine/methylmalonic acid
- no iron studies

Causes:
- vegan/vegetarian diet
- alcoholism
- pernicious anemia (lack intrinsic factors)
- decreased absorption (Crohn’s)
- Medications (PPI, Metformin)

Side effects –> MUST ABSORB FROM DIET
- weakness, numbness, cognitive dysfunction

25
Q

Treatment of Vitamin B12 Deficiency Anemia

A

IM/SubQ
- 100-1000 mcg daily, then weekly, then monthly

Oral
- 1000-2000 mcg/day
** may be less effective for pernicious anemia

WATER SOLUBLE VITAMIN

26
Q

Folic Acid Deficiency Anemia

A

Bloodwork
- decreased Hb
- increased MCV
- increased RDW
- decreased serum folate
- increased homocysteine
- no iron studies

Causes:
- malabsorption
- malnutrition
- alcoholism
- Medications (methotrexate, phenytoin, sulfasalazine, Bactrim)

27
Q

Treatment of Folic Acid Deficiency Anemia

A

Oral Folic Acid
- 1 to 5 mg daily until Hb normalizes

** ALWAYS CHECK VITAMIN B12 **

WATER SOLUBLE VITAMIN

Repletion:
- 3 to 6 months

28
Q

Anemia of Chronic Disease

A

Diseases:
- CKD
- CHF
- Cancer
- HIV/AIDs

Occurs because:
- decreased erythropoietin production
- chronic inflammatory state
- nutritional deficiencies (iron, folate, vitamin B12)

29
Q

Treatment of Anemia of Chronic Kidney Disease

A

Avoid blood transfusions
- risk of allosensitization

Correct Nutritional Deficiencies
- Folate
- B12
- Iron
** CKD Stage 3-5: oral
** CKD HD: IV
** TSAT > 30% goal

Erythropoiesis Stimulating Agents (ESA)
- prevents blood transfusions
- DO NOT TARGET NORMAL HB (maintain Hb > 10)
- Side effects: CV events, stroke, death
- only start after replenishing iron stores
- do not titrate dose up for at least 4 weeks after initiating

30
Q

Anemia of Chronic Heart Failure

A

May benefit:
- NYHA Class II or III
AND
- iron deficiency (ferritin < 100 or 100-300 if TSAT > 30%)

31
Q

Treatment of Anemia of Chronic Heart Failure

A

NO ORAL IRON

NO ESA

32
Q

Treatment of Blood Loss Anemia

A

STOP THE BLEEDING

Transfuse packed RBC if Hb < 7
- each unit of RBC contains 250 mg of iron
- 1000 mg of iron to replete stores

33
Q

Hemolytic Anemia

A

RBC destroyed before 120 days

Types:
- sickle cell anemia
- G6PD deficiency
- drug induced

34
Q

Sickle Cell Anemia

A

What?
- RBC are irregular shaped and collects in the spleen and destroyed faster than production
- homozygous recessive

35
Q

Treatment of Sickle Cell Anemia

A

Folic Acid: 1 mg/day

Blood Transfusions: symptomatic episodes of acute/chronic

Hydroxyurea
- fetal hemoglobin inducer leading to decreased sickling
- 10-15 mg/kg/day

Immunizations

Pain Control
- Tylenol
- NSAIDs
- opioids –> PCA

PHRM 864 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions