Anemia

Question 1

most iron in food is present as

Answer 1

ferric hydroxide

Question 2

which form of iron is more rapidly absorbed

Answer 2

ferrous

Question 3

where does iron absorption occur

Answer 3

duodenum

Question 4

Simultaneous ingestion of _______ & _______ help increase ferrous and absorption

Answer 4

vit C

HCL

Question 5

over dose causes necrotizing gastritis, vomiting, abdominal pain and bloody diarrhea

Answer 5

iron toxicity

Question 6

Tx for iron over dose

Answer 6

whole bowel irrigation

deferoxamine

Question 7

iron chelating agent

binds to iron that has been absorbed to promote excretion in iron overdose

Answer 7

deferoxamine

Question 8

iron therapies

Answer 8

1) Fe deficiency due to diet
2) pregancy
3) malabsorption syndromes - celiac dz
4) premature babies
5) chronic GI bleeding
6) heavy menstruation

Dx: decrease MCV (microcytic), decrease MCH & MCHC (hypochromic)

Question 9

oral therapy

Answer 9

only established Fe deficient anemia
oral Fe to replenish Fe stores
30% Fe given as drug is absorbed
requires long term therapy (up to 6 mon.)

Question 10

Oral preparations

Answer 10

Ferrous sulphate - given on full stomach
Ferrous gluconate - tried w. tolerance to sulphate
Ferrous fumarate - tried w/ tolerance to sulphate

Question 11

ADR: black feces, GI symptoms: nausea, abdominal pain, constipation or diarrhea

Answer 11

oral therapy

Question 12

when iron can not be absorbed from intestine
px can not be relied on to take oral drugs
px not able to tolerate GI symptoms

Answer 12

parenteral iron therapy

Question 13

parenteral preparations

Answer 13

iron sorbitol - IM
iron dextran - IV
iron sucrose - IV

Question 14

ADR: headache, dizziness, nausea, disorientation, metallic taste, urticaria, hypotension and w/ IV drugs – anaphylactoid reactions can occur

Answer 14

parenteral iron therapy

Question 15

leads to

1) megaloblastic anemia = macrocytic normochromic anemia
2) degeneration of brain, spinal cord, peripheral nerves
3) abnormalities of epithelial tissue (sore tongue & malabsorption)

Answer 15

B12 def

Question 16

RBCs maturation arrested
pro erythroblasts and early normoblasts seen
Dx: increase MCV & MCH and normal MCHC

Answer 16

megaloblastic anemia

Question 17

Indictions

1) pernicious anemia
2) malabsorption syndromes

Answer 17

B12 Def

Question 18

due to lack of two enzymes

1) extrinsic: cyanocobalamin
2) intrinsic: glycoprotein secreted by parietal cell of fundus and cardia

Answer 18

pernicious anemia

Question 19

stagnant loo syndrome
ileal resection
chrons dz

Answer 19

examples of malabsorption

Question 20

pernicious anemia give as IM

all other cases give oral

Answer 20

Treatment for B12

Question 21

1) converted in body to bioactive coenzyme tetrahydrofolic acid
2) imp in biosynthesis if amino acids and DNA
3) leads to megaloblastic anemia [Inc -MCV, MCH, N- MCHC]

Answer 21

folic acid def

Question 22

indictions

1) prevent/cure def
2) pregnancy
3) dietary def
4) prevent of NTD
5) premature infants
6) malabsorption syn.
7) drug therapy (phenytoin, phenobarbital, MTX)

Answer 22

folic acid def

Question 23

1) glycoprotein produced in kidneys
2) regulates RBC proliferation and differentiation in bone marrow
3) used in combo with iron supplement
4) given subQ or IV

Answer 23

erythropoietin

Question 24

used in treatment of anemia in

1) end stage renal disease
2) anemia in HIV
3) anemia in cancer tx

Answer 24

Erythropoietin

Question 25

ADR: elevated BP, iron def

Answer 25

Erythropoietin