anemia

Question 1

RBC characteristics

Answer 1

120 days
shape- poikilocytosis
size- anisocytosis
color- polychromasia

95% dry weight is hemoglobin

Question 2

hemoglobin

Answer 2

women 12-16 g/dL
men 13-18 g/dL

if below 7-8 then fix with PRBC (1-2 units)

Question 3

hematocrit

Answer 3

ratio of RBC to total blood volume

women 36-45%
men 38-50%

Question 4

reticulocyte

Answer 4

high- replacing lost

low- bone marrow failure

Question 5

RDW

Answer 5

red cell distribution width

variation in size

Question 6

MCV

Answer 6

mean corpuscular volume
Size

> 100 fL/cell=macrocytic
80-100 fL/cell=normocytic
<80 fL/cell=microcytic

Question 7

MCH

Answer 7

mean corpuscular hemoglobin

26-34 pg/cell

Question 8

MCHC

Answer 8

mean corpuscular hemoglobin concentration
31-36 g/dL

high- hyper chromic
normal- normochromic
low- hypo chromic

Question 9

iron deficiency

Answer 9

pale, fatigue, tachycardia
sore smooth tongue w/atrophy on dorsal filiform
pica, unusual craving for specific foods

most common form of anemia
serum  LOW
TIBC  HIGH
Serum ferritin  LOW
VS CHRONIC DISASE
serum  LOW
TIBC  LOW OR NORMAL
serum ferritin  HIGH OR NORMAL

decreased
hemoglobin, hematocrit
MCV
MCH/MCHC
reticulocyte count

stool guaiac
pos if GI tract bleed

Question 10

serum iron

Answer 10

women 40-150 ng/mL

men 50-160 ng/mL

Question 11

TIBC

Answer 11

total iron binding capacity
250-450 ug/dL
transferrin (20-50% bound to iron)

Question 12

ferritin

Answer 12

stored iron
women 4-160 ng/mL
men 16-300 ng/mL
acute phase rx in inflammation

Question 13

tx of iron anemia

Answer 13

Fe salts
PO: FERROUS SULFATE, ferrous gluconate, ferrous fumarate
IV: Iron dextran, iron sucrose, ferric gluconate, ferric
pyrophosphate citrate, ferric carboxymaltose

PO iron preferred over IV iron
325 mg TID = 200 mg elemental iron daily (goal)

Question 14

tx of iron anemia adverse effects

Answer 14

GI- N/V
constipation
black stools

Quinolone, tetracylcine, thyroid
SO take at least 2 hours apart from iron

Question 15

response to tx of iron anemia

Answer 15

5-10 days
3-6 mo to replenish iron stores completely
1-2 g/dL each week

orange juice doubles absorption