Anemia Flashcards
What are the 3 common causes of anemia?
↑Blood loss
↑RBC destruction
↓RBC production
What are common etiologies of anemia?
Common in pregnant women : 2-3x ↑risk for low birth wt, preterm delivery, perinatal mortality
Women taking OCP, have IUDs, are menstruating
Chronic Kidney dz (give EPO)
DDX of iron deficiency anemia, which is most common?
Occult bleeding (most common) Dietary deficiency CKD Pregnancy low testosterone lead poisoning
S/S of Anemia
Constitutional: fatigue, weakness, HA, irritability
CV: palpitations, tachy, orthostatic hypotension, dizziness, syncope
Pulm: SOB
Skin: pallor, purpura, petechiae, jaundice
Abdomen: occult blood, ascites
S/S of iron deficiency anemia
Pagophagia (craving ice)
Pica
Angular cheilitis (glossitis)
Koilonychia (nail spooning)
what labs are needed in the w/u for anemia?
CBC w/ RBC indices + iron study Pregnancy test (postmenopausal women only)
**don’t forget about the labs in w/u of fatigue (they are usually included)
what labs can you use to differentiate B12 vs Iron def.
Homocysteine and Methylmalonic acid
what is the Tx for iron deficiency anemia?
How long is tx required?
1: tx the cause of the anemia, then work to normalize labs.
- 120 mg/day iron required for tx, ↑1b/dL hemoglobin after 1 month is proof of adequate response
- tx is required for 3 months after anemia is corrected to replenish iron stores - refer to a specialist when needed
What are some pt education tips you may give to your pt with anemia?
Take Rx as prescribed
If new sx present, dark tarry stools, sx worsen = come back
May take a few weeks before sx improve
f/u in 4 weeks to check tx adequacy, then check periodically
What will happen with the following labs if a pt has iron deficiency anemia
Serum iron?
Serum transferrin (total iron binding cap.) ?
transferring saturation?
Serum ferritin?
Soluble serum transferring receptor?
Serum iron : ↓ Serum transferrin (total iron binding cap.): ↑ transferring saturation: ↓ Serum ferritin: ↓ Soluble serum transferring receptor: ↑
What will happen with the following labs if a pt has anemia of chronic dz
Serum iron?
Serum transferrin (total iron binding cap.) ?
transferring saturation?
Serum ferritin?
Soluble serum transferring receptor?
Serum iron: ↓
Serum transferrin (total iron binding cap.): ↓
transferring saturation: ↓
Serum ferritin : normal
Soluble serum transferring receptor: normal
what are common causes of iron deficiency anemia?
Inadequate intake
↓ Absorption (recent GI surgery, Celiac dz)
↑ Iron loss
who should be screened for iron deficiency anemia?
Symptomatic adults
Pregnant women
Children at 1 yr old
