Anemia

Question 1

3 categories of anemia

Answer 1

Microcytic hypochromic
Macrocytic normochromic
Normocytic normochromic

Question 2

Microcytic hypochromic

Answer 2

Thalassemias, bone marrow failure, chronic disease, IDA

Question 3

Microcytic hypochromic

Answer 3

Thalassemias, bone marrow failure, chronic disease, IDA
Low RBC, Hgb/Hct, low MCV and MCHC
High risk for iron deficiency

Question 4

Macrocytic normochrmoic

Answer 4

Drug induced
B12 deficiency (vegans at risk, yo)
Folate deficiency (Alcoholics)

Question 5

Normocytic normochromic

Answer 5

Acute hemorrhage, blood parasites, bone marrow failure, systemic/chronic disease, hemolytic anemias
Low RBC, hgb/Hct, normal indices
MC in ambulatory western patients!
THESE WILL NOT RESPOND TO NUTRITION UNLESS COEXISTENT DEFICIENCY

Question 6

Which conditions can lead to normocytic or microcytic anemia

Answer 6

Bone marrow fakilure: sideroblastic anemia (more often micro)
Chronic diseasE: inflammatory disease, infection, malignant disease

Question 7

DDX and management of the 3 major anemias:

IDA

Answer 7

IDA: r/o GI bleed, then supplement with iron for several months. Avoid ferrous sulfate supplements, non-enteric capsules, increase dietary iron, avoid tea/coffee, serum ferritin

Question 8

DDX and management of the 3 major anemias:

Folic acid deficiency

Answer 8

Folic acid supplements, B12 supplements, serum folate and serum b12 (folic acid masks b12)

Question 9

DDX and management of the 3 major anemias:

Vb12 deficiency

Answer 9

With/without pernicious anema = supplement with b12

Question 10

Substances that inhibit iron absorption (3)

Enhance iron absorption (3)

Answer 10

Enhance: vitamin A, C, betaine HCl
Inhibit: tea, coffee, enteric coated capsules

Question 11

Iron supplement form that causes GI side effects

Answer 11

Ferrous sulfate

Question 12

Effectiveness of b12 supplements orally when malabsorption = cause of b12 deficiency?

Answer 12

Still effective