Anemia Flashcards
life span of RBCs
120 days
MCV microscopic < 80
Likely iron deficiency
MCV normocytic 80-100
Acute blood loss, CKD, aplastic anemia (bone marrow failure)
MCV macrocytic >100
Vit B12 or folate deficiency
Iron studies- iron stores
Ferritin
Iron studies- bound to transferrin
Serum iron
Iron studies- transferrin saturation
Amount of transferrin binding sites occupied by iron
Iron stores- total iron binding capacity
Amount of transferrin binding sites available to bind iron
More readily absorbed iron
Heme iron - found in meat and seafood
Non-heme iron
Found in nuts, beans, veg, fortified grains and cereals
Gluconate
12% elemental
Sulfate
20% elemental
30% if dried
Fumarate
33% elemental
Iron supplement counselling
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
Pernicious Anemia
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
Long term (over 2 yrs) of Metformin and PPIs/H2RAs can lead to _____ deficiency
Vit B12
Erythropoietin (EPO)
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
ESAs
Epoetin Alfa (3x/wk) Darbepoetin (1x/wk)
Hemolytic anemia
When RBCs are destroyed and removed from bloodstream before their normal 120 day lifespan
-can be drug-induced or G6PD deficiency
Drugs that cause hemolytic anemia
Dapsone Methylene blue Primaquine Valproic acid Cephalosporins Nitrofurantion Penicillins Levodopa Pegloticase/rasburicase
