Anemia Flashcards
3 major causes of anemia
Increased Destruction of RBCs (hemolysis)
Autoimmune hemolytic problems
Blood Loss (acute or chronic)
Decreased Production of RBCs
Nutritional, ACD,
bone marrow suppression
RDW
looks at different sizes of cells. Anemia is going to be increased b/c the bone marrow will be trying to spit out RBCs as fast as possible
Retic count
immature blood cells
MCV is measured by what? and normal level
Cytic -size, 80-100
How much elemental iron is absorbed when 200-300mg elemental iron given?
50-60mg/day
Iron Tolerance Test and how much will the normal absorption increase the serum iron level by?
two iron tablets given on an empty stomach and the serum iron level measured over the next two hours. Normal absorption will result in increaseincrease of serum iron level by 100 ug/dL
How much elemental iron is in a 325mg ferrous sulfate tab?
65mg & only 25% is absorbed
A target Hgb for anemia of chronic disease, it should not exceed what
11 to 12 g/dL,
hemoglobin should not exceed 13 g/dL.
intrinsic factor involves the destruction of what cells
parietal cells
presentation of Prenicious anemia
weakness, sore tongue, and paresthesias, weight loss, increased cardiac output, tachycardia
B12 deficiency treatment
daily subq for 1 week then twice a week for another 4-5 weeks. Then 100 µg once a month
OR
once a week injections of 1000 µg for 5-6 weeks, followed by monthly injections.
If patient has neurological symptoms with B12 deficiency, how should you treat them? IM/subq or PO?
IM/subq
MCV <80
Microcytic
how do children with sickle cell with acute chest syndrome usually present
fever, chest pain, cough, tachypnea, leukocytosis, and pulmonary infiltrates in the upper lobes
how to adults with sickle cell with acute chest syndrome usually present
afebrile, dyspneic with severe chest pain, with multilobar/lower lobe disease
children present with fever
what is a serious complication of sickle cell disease
pulmonary hypertension
what happens to the ventricles in sickle cell disease
they dilate
GU complications with sickle cell
Kidneys lose concentrating capacity; priapism
Dermatologic complication’s with sickle cell
Leg ulcers are a chronic painful problemvaso-occlusive crises. The frequency of crises is extremely variable. Some individuals have as many as 6 or more episodes annually, whereas others may have episodes only at great intervals or none at all.
2 evidenced based treatment of Sickle cell disease
to use Hydroxyurea (anti-cancer) and long-term, periodic blood transfusions
Treatment of vast occlusive crisis in the hospital for SCD
Rapid initiation of opioids for the treatment of severe pain associated with a vaso-occlusive crisis
Use of analgesics and physical therapy for the treatment of avascular necrosis
Which oral antibiotic is used prophylactically for SCD in children up to 5 years?
penicillin
Annual transcranial Doppler examinations should be done for SCD between which ages. And what should they be getting if abnormal transcranial Doppler velocity (≥200 cm/s) to prevent stroke in children?
ages of 2 and 16
Long-term transfusion therapy
In patients with sickle cell anemia, preoperative transfusion therapy should be used to increase hemoglobin levels to
10 g/dl
MCH and level
Chromic, color, normal:27-31
normal retic count
0.5-1.5.
normal iron levels
50-150
normal transferrin level
200-430
Normocytic anemias are due to what
blood loss or chronic disease
what tests should be done with microcytic anemias?
Iron studies (ferritin, TIBC etc) and lead studies
what test do you do to differentiate between sickle cell anemia and thalassemia?
Hemoglobin electrophoresis
What will sed rate, TIBC, and ferritin levels be? (high or low)
Sed rate will be increased, TIBC will be low, Ferritin will be high
what will Sickle cell MCV be?
normoncytic
celiac and chrons can cause what anemia?
pernicious (B12 deficiency)
normal Hgb
12-18
normal Hct
40-54%
vegetarians should take which supplements?
B12
triggers for sickle cell crisis
dehydration, fever, cold, hypoxemia
If patient has neurological symptoms of B12 deficiency how do you treat?
SubQ forever even after the reach therapeutic levels
