anemia Flashcards
Red blood cells last how long
120 days
About how many RBC are produced each day
About 200 million
released into peripheral blood
What is anemia?
A condition characterized by a decrease in Hgb or RBC
How is anemia classified? (3)
• Mild = hgb 10-12
Moderate = 8- 12
severe- <8
Morphological Classes of anemia? (3)
– Megaloblastic
normocytic
microcytic
Megaloblastic are what?
large nucleated RBC precursors
What is megaloblastic usually associated with?
Typically associated with folic acid or vit B12 deficiency
inadequate intake
decreased absorption
inadequte utilization
Microcytic RBC are what?
Small RBC
Microcytic anemia is usually associated with?
Typically associated with iron deficiency due to inadequate iron intake inadequate iron absorption increased iron demand blood loss chronic disease
lack of 3 nutrients to make RBCs that could cause anemia?
– Iron
– Folic
–vit B12
what can cause a loss of RBC that could cause anemia?
– Hemorrhage
– Hemolytic
Etiology Reduced lifespan of RBC
– Chronic diseases
hemolysis
Lack of stimulus to make RBC’s
Lack of ability to make RBC
stimulus= decreased erythropoiten production make= impaired bone marrow function
Acute onset of anemia consists of 3 symptoms
Tachycardia, lightheadedness, breathlessness
6 symptoms of chronic anemia?
Fatigue, H/A
vertigo, faintness, cold sensitivity,
pallor, loss of skin tone
What are some diagnostic labs for anemia?
• CBC, WBC, HCT, Hgb, platelets stool guiac peripheral blood smear reticulocyte count mean corpuscular volume mean corpuscular hemoglobin conc mean corpuscular hemoglobin
Iron deficiency Anemia
• Results from a negative iron balance
very small amount of iron are eliminated each day
What are some symptoms of iron deficiency
spooning of nails brittle nails cheilosis fatigue pallor
Risk factors of iron deficiency anemia
– Premature infants children in rapid growth periods pregnant and lactating women after gastrectomy menstruation GI bleed chronic hemodialysis
Labs seen in patients with iron deficiency anemia
– Low MVC Low MCHC, MCH Low serum ferritin Low transferrin saturation increase TIBC increase transferrin
What is TIBC
increase amount of iron able to bind to transferrin
Why is there low transferrin saturation in iron def anemia?
due to less iron to transport on more transferrin available
what are 4 goals to treatment of iron deficiency anemia?
– Alleviate symptoms
correct iron def
increase Hgb
prevent recurrence
What needs to be included in someone with iron def anemias DIET?
– Meat, fish, poultry
plant sources are more difficult for body to extract iron
What are 4 types of oral supplements used for treatment of iron deficiency anemia?
• Ferrous sulfate** (60 mg elemental) ferrous gluconate (37) ferrous fumarate (33) polysaccharide iron complex (100)
What is the aim for oral iron supplements?
Approximately 200 mg/day elemental iron
Parenteral Iron is used in cases of? (3)
– iron malabsorption
intolerance oral therapy
chronic non compliance
What are some examples of parenteral iron? (4)
iron dextran sodium ferric gluconate (ferrlecit) iron sucrose (venofer) ferumoxytol (feraheme) all given IV used for maintence and prevention
How do you monitor iron deficiency anemia?
weekly CBC, iron panel, Hgb
What should you expect to see in the first few weeks of treatment for iron deficiency anemia?
see increase in reticulocyte count within 7 days due to increase RBC synthesis
increase in Hgb in 1-2 weeks
3-6 months to normalize everything