Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHRM 825 > Anemia > Flashcards

Anemia Flashcards

1
Q

Anemia

A

lack of blood and oxygen

decrease in RBC and decrease Hgb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define Signs and Symptoms of Anemia

A

exertional dyspnea- shortness of breath with exercise

angina-not enough oxygen to the heart leading to chest pain

tachycardia-not enough blood or oxygen getting into tissue, the body will try to fix it by pumping faster

fatigue-not enough oxygen, feel tired and weak
pallor
anemia may be asymptomatic especially if it develops slowly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

RBC Lab Value (normal)

A

of RBCs estimate oxygen carrying capacity

males: 4.5-5.5 x 10^6
females: 4.1-4.9 x 10^6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hgb Lab Value (normal)

A

oxygen carrying capacity

males: 13.5-18g/dL
females: 12-16g/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hematocrit Lab Value (normal)

A

volume of RBCs per unit of blood

38-50%: male
36-46.6%: female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mean Corpuscular Volume (normal)

A

average volume of RBCs help determine what might be the case of anemia

80-100mm^3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

RDW Lab Value (normal)

A

Red blood cell distribution width

11.5%-14.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

T/F: Iron Supplementation is the first line treatment of anemia

A

F: iron supplementation is not the first line treatment of anemia
-you have to assess what is causing the anemia, it will only be useful for iron deficiency anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Decreased RBC Production

cause of anemia

A

caused by chronic diseases
(CKD, cancer, CHF)
nutritional deficiency-lack building blocks to make RBCs
iron, folic acid, vitamin B12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Increased RBC Destruction

cause of anemia

A

drugs
sickle cell anemia
thalassemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Increased Red Blood Cell Loss

cause of anemia

A

acute blood loss

chronic NSAIDs/ ASA (aspirin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Microcytic Anemia

A

MCV <80

iron deficiency, sickle cell, thalassemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The most common cause of microcytic anemia and anemia in general

A

Iron deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Normocytic Anemia

A

MCV 80-100

anemia of chronic disease, blood loss, hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Macrocytic Anemia

A

MCV >100

folic acid or B12 deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Consequences of Anemia

A

what providers want to prevent happening

impaired cognitive function 
atrial fibrillation 
falls
heart failure
cardiovascular events
mortality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Goals of Therapy

A

increase Hgb
relieve symptoms: fatigue
reduce morbidity
improve the quality of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Iron Deficiency Anemia

A 
decreased Hgb
decreased MCV
decreased ferritin 
increased TIBC/transferrin 
increased/ normal RDW
decreased/ normal serum iron
decreased TSAT

(next step is to conduct iron studies)

19
Q

Ferritin

A

15-200ng/mL
decreased in iron deficiency
tells you about the stores you have in your body
ferritin <15 you for sure have iron deficiency anemia
ferritin <50 iron deficiency anemia and you still treat it

20
Q

Iron

A

40-160mcg/dL
decreased in iron deficiency

tells you the concentration of iron bound to transferrin

21
Q

Transferrin

A

200-360 mg/dL
increased in iron deficiency

  • protein that delivers iron throughout the body
  • body is triyng to compensate and get an elevated transferrin
22
Q

TIBC (Total Iron Binding Capacity)

A

250-400 mcg/dL
increased in iron deficiency

-concentration of iron if all transferrin was bound to iron

23
Q

TSAT (Transferrin Saturation)

A

20-50%
decreased in iron deficiency

-amount of iron ready for eryhtropoeisis

24
Q

Causes of Iron Deficiency

A
  • blood loss-mensturation/donation
  • decreased absorption -celiac disease, gastric bypass, maxnimal absorption in the duodenum
  • vegetarian diet-dietary iron heme, non-heme
  • increased consumption-pregnancy
25
Q

Additional Signs and Symptoms

A
  • koloinychias-spoon shaped nails
  • inflammed tongue- glossitis
  • pica- craving substances that don’t have nutritional value
    pagophagia: ice
    geophagia: dirt, soil, clay
26
Q

Iron Deficiency Anemia Treatment

A

Oral Iron preferred over IV

IV used:

  • cannot tolerate (side effects)
  • cannot absorb
  • end stage renal disease (ESRD)

need 120-200 mg elemental iron per day

27
Q

Counseling Points

A
  • taken once daily-three times daily
  • increased absorption on empty stomach
  • causes upset stomach-can take with food or split doses
  • causes constipation-increases fluid, activity, and fiber
  • causes dark stools-may be mistaken for GI bleed
  • can be mistaken for candy by kids-can result in overdose in children-fatal
28
Q

IV Iron

A

indications: ESRD, failed oral iron, malabsorption

side effects: hypotension during infusion (common), skin tattooing

29
Q

Vitamin B12 Deficiency Anemia

A
  • decreased Hgb
  • increased MCV
  • increased RDW
  • decreased B12 (<200pg/mL)
  • normal ferritin/TIBC/transferrin
  • normal serum iron/transferrin saturation (TSAT)
  • increased homocysteine /methylmalonic acid
30
Q

Causes of Vitamin B12 Deficiency Anemia

A 
a vegan/vegetarian diet 
alcoholism 
decreased absorption (Crohn's disease) 
lack of intrsinsic factor (pernicious anemia) 
-positive shilling test
medication

our bodies cannot make enough Vit B12-must absorb from diet
consequences: neurologic, weakness, numbness, cognitive dysfunction

31
Q

Treatment of Vitamin B12 Deficiency Anemia

A

Vit B12 replacement (not effective in pernicious anemia: lack intrinsic factor to absorb Vit B12)
IM or Deep SC: 100-1000 mcg (regimens vary)
often daily for 1-2 weeks, then weekly or monthly as maintenance
H20 soluble vitamin

oral is as effective as parenteral

32
Q

Folic Acid Deficiency Anemia

A 
decreased Hgb 
increased MCV 
increased RDW
normal ferritin/transferrin 
normal serum iron/TSAT 
decreased folate
increased homocysteine
33
Q

Causes of Folic Acid Deficiency Anemia

A

malabsorption
malnutrition: found in green vegetables, orange juice, cereal, and milk
alcoholism: no nutrients in alcohol
medications: antibiotics work by inhibiting folic acid
(methotrexate, phenytoin, sulfasalazine, sulfamethoxazole/trimethoprim)

34
Q

Treatment of Folic Acid Deficiency Anemia

A

oral folic acid supplement
1-5mg daily until Hgb normalizes
well absorbed, rarely need IV
treat the underlying cause/continue to supplement

never replace folic acid without checking vitamin B12 deficiency

35
Q

Anemia of Chronic Disease

A

one of the most common causes of anemia
patients with chronic disease lasting months to years:

CKD, CHF, Cancer, HIV/AIDS

36
Q

Anemia of CKD

A

erythropoietin is produced in the kidneys and stimulates the production of RBCs

  • decreased RBC production
  • chronic inflammatory state which causes anemia of chronic disease
  • nutritional deficiencies (iron, folate, Vit B120)
37
Q

Treatment of Anemia of Chronic Disease

A

avoid blood transfusions-more at risk of allosensitization
-correct nutritional deficiencies: folate B12 and iron

ESAs:
help prevent blood transfusions
maintain Hgb> 10- once this level is achieved, no need to keep going due to increased risk of adverse effects

38
Q

Blood Loss Anemia

A

treatment: stop bleeding
transfuse packaged RBCs when Hgb is <7: each unit of RBCs ~250 mg iron
medications may be indicated for specific conditions

39
Q

Hemolytic Anemia

A

RBCs are destroyed before the 120-day lifespan

inherited: sickle cell anemia, glucose-6-phosphate (G6PD) dehydrogenase
acquired: drug induced

40
Q

Sickle Cell Anemia

A

RBCs are irregular in shape (sickled)
RBCs collect in spleen and are destroyed faster than they can be produced
sickle cell trait: asymptomatic
sickle cell anemia: both genes are sickle cell Hgb (homozygous)

41
Q

Treatment of Sickle Cell Anemia

A

folic acid
increased the need for folic acid due to accelerated erythropoiesis

blood transfusions
symptomatic episodes of acute or chronic anemia
iron overload from frequent transfusions

hydroxyurea:
fetal hemoglobin inducer
decreases sickling
10-15mg/kg/day

42
Q

Immunizations-Sickle Cell Anemia

A

impaired splenic function
risk of infection from encapsulated organisms

influenza, pneumococcal, and meningococcal vaccinations

43
Q

Pain Control -Sickle Cell Anemia

A

acetaminophen/NSAIDS
opioids in pain crisis
-may use patient controlled analgesia

44
Q

Drug Induced Anemia

A

drugs can cause anemia and they can do it in several different ways

drug aplastic anemia
drug induced immune hemolytic anemia
drug induced oxidative hemolytic anemia: (patients with G6PD enzyme deficiency)
drug induced megaloblastic anemia

PHRM 825 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions