Anemia

Question 1

life span of RBCs

Answer 1

120 days

Question 2

MCV microscopic < 80

Answer 2

Likely iron deficiency

Question 3

MCV normocytic 80-100

Answer 3

Acute blood loss, CKD, aplastic anemia (bone marrow failure)

Question 4

MCV macrocytic >100

Answer 4

Vit B12 or folate deficiency

Question 5

Iron studies- iron stores

Answer 5

Ferritin

Question 6

Iron studies- bound to transferrin

Answer 6

Serum iron

Question 7

Iron studies- transferrin saturation

Answer 7

Amount of transferrin binding sites occupied by iron

Question 8

Iron stores- total iron binding capacity

Answer 8

Amount of transferrin binding sites available to bind iron

Question 9

More readily absorbed iron

Answer 9

Heme iron - found in meat and seafood

Question 10

Non-heme iron

Answer 10

Found in nuts, beans, veg, fortified grains and cereals

Question 11

Gluconate

Answer 11

12% elemental

Question 12

Sulfate

Answer 12

20% elemental

30% if dried

Question 13

Fumarate

Answer 13

33% elemental

Question 14

Iron supplement counselling

Answer 14

Take on empty stomach
Avoid H2RAs and PPIs, separate from antacids
SE: constipation, dark tarry stools, N, upset stomach
Separate from Quinolones and Tetracyclines, Bisphosphonates, levothyroxine

Question 15

Pernicious Anemia

Answer 15

Most common cause of Vit B12 anemia

• lack of intrinsic factor which is required for B12 absorption in the small intestine
• need lifelong parenteral Vit B12

Question 16

Long term (over 2 yrs) of Metformin and PPIs/H2RAs can lead to _____ deficiency

Answer 16

Vit B12

Question 17

Erythropoietin (EPO)

Answer 17

A hormone produced by the kidneys that stimulate the bone marrow to produce RBCs
-anemia of CKD is primarily due to a lack of EPO

Question 18

ESAs

Answer 18

Epoetin Alfa (3x/wk)
Darbepoetin (1x/wk)

Question 19

Hemolytic anemia

Answer 19

When RBCs are destroyed and removed from bloodstream before their normal 120 day lifespan
-can be drug-induced or G6PD deficiency

Question 20

Drugs that cause hemolytic anemia

Answer 20

Dapsone
Methylene blue
Primaquine
Valproic acid
Cephalosporins
Nitrofurantion 
Penicillins
Levodopa
Pegloticase/rasburicase