Anemia

Question 1

Classification of Iron Deficiency Anemia

Answer 1

microcytic

Question 2

Oral iron preparations examples

Answer 2

Ferrous sulfate - least expensive, most commonly used
Ferrous gluconate
Ferrous fumarate
Iron bisglycinate/protein succinylate - most expensive, fewer side effects

Question 3

Oral iron preparations - interactions

Answer 3

Food decrease uptake by 40-60%.
Caffeinated beverages
Calcium supplements and calcium containing foods/drinks
H2 receptor blockers
PPIs

Vitamin C enhances absorption

Question 4

Duration of treatment of uncomplicated iron deficiency anemia

Answer 4

3-6 months

Question 5

Iron salts - adverse effects

Answer 5

GI – constipation, discolored stool, nausea/vomiting

Question 6

Suggestions for tolerating oral iron

Answer 6

Increasing dosing interval
Taking with food (understanding this may decrease absorption)
Switching to liquid- easier to make small dosing adjustments
IV preparations available if unable to tolerate oral

Question 7

What parenteral iron preparation has fewer adverse effects?

Answer 7

Low-molecular-weight preparation of iron dextran.

Question 8

Classification of folate or B12 deficiency anemias

Answer 8

Macrocytic

Question 9

B12 deficiency symptoms

Answer 9

Paleness, fatigue
Smooth tongue
Nerve symptoms (numbness/tingling)

Question 10

B12 supplementation options

Answer 10

Oral supplement - if suspect deficieny related to diet/malbutrition
SQ/IM injection if pernicious anemia

Question 11

Causes of B12 deficiency

Answer 11

• decreased absorption due to lack on intrinsic factor (made from parietal cells in the stomach)
• can be caused by GI surgery, diseases of the ilium, constipation - pernicious anemia d/t malabsorption issues
• Vitamin B12 is needed for the final steps of folate metabolism

Question 12

Classification of anemia of chronic disease

Answer 12

normocytic, sometimes microcytic