Anemia Flashcards
Causes of B12 deficiency
pernicious anemia
gastrectomy
distal ileum defects (malabsorption, inflammed bowel, small bowel resection)
Rare: bacterial growth of small bowel, chronic pancreatitis, thyroid disease
Kids: IF defects
Folic acid is precursor for
synth of amino acids, DNA, purines
*reduced form required
Causes for folic acid deficiency
alcoholism/ liver disease pregnant women hemolytic anemia malabsorption syndromes renal dialysis
Alcoholics and liver disease patients can have deficiency of
folic acid
cardiovascular adaption for iron deficiency
tachycardia
increased cardiac output
vasodilation
most common cause of chronic anemia
iron deficiency
symptoms of iron deficiency (chronic anemia)
pallor, faitgue, dizziness, exertional dyspnea, tissue hypoxia
increased iron requirements for
pregnant women, kids, menstruating females
unexplained iron deficiency
GI bleed *esp in post menopausal women and old people
acute iron toxicity symptoms
necrotizing gastroenteritis, vomiting, abdominal pain, bloody diarrhea
Shock, lethargy, dyspnea, metabolic acidosis,
coma, death
treatment for chronic iron overload without anemia
phlebotomy
What is B12? What does it do?
Cofactor required for dTMP production needed for DNA synthesis
B12 deficiency leads to
megaloblastic anemia
GI symptoms
neurologic abnormalilties (may not be reversible if not caught in time)
What type of iron can be absorbed by the body?
Ferrous (Fe++)
How is ferric iron administered?
Parenterally via colloid suspensions with iron core surrounded by carbohydrate
Rare but life threatening adverse effect of iron dextran
hypersensitivity –> anaphylaxis and death
What deficiency can be caused by methotrexate? How is this problem solved?
folic acid, administration of leucovorin (reduced folate) to rescue cells not targeted by mtx
What is different between Epoetin-alpha and darbepoetin?
darbepoetin is longer lasting
Black box warnings for Epoetin-alpha? How should this effect administration?
pts with chronic kidney disease and cancer.
The lowest dose possible to prevent transfusion need should be administered avoid
What growth factor is used to mobilize PBSCs from the bone marrow?
G-CSF (filgrastim)
What does GM-CSF act with to stimulate T cell proliferation
IL-2
Which growth factor has a broader spectrum? G-CSF or GM-CSF
GM-CSF: acts on granulocytic progenitors
G-CSF: only neutrophils and their progenitors
Which GF has greater toxicity? G-CSF or GM-CSF?
GM-CSF: esp. at higher doses
-allergic rxn, edema, pleural and pericardial effuions
What should be given to increase platelets via IL-11 receptors?
oprelvekin (rh-IL-11)
