Anemia and HGF Crossword Flashcards by Charles Leclerc

Frequently head in anemia, because the thinner blood leaks through the closed valves

Murmur

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Common symptom of anemia

Fatigue

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Consequence of peripheral vasodilation due to oxygen-poor blood causing elevated heart rate

Low Pressure

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Can cause the elastin-rich eye to turn yellow

Hemolysis

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Common in anemia due to decreased oxygen carrying capacity of blood causing elevated heart rate

Angina

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Releases Erythropoietin in response to hypoxia; failure of this organ causes a normochromic normocytic anemia

Kidney

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Anemia in which erythroblasts double protein but were unable to synthesize new DNA; extrusion of nucleus now leaves a large RBC

Macrocytic

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Hypersegmented in macrocytic anemia

Neutrophils

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Anemia in which the MCV <80 fL; iron deficiency is the most common cause

Microcytic

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This for macrocytic anemia is aided by measuring plasma levels of folate, vitamin B12, homocysteine and methyl-malonic acid

Diagnosis

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Sign of anemia that can be evident from a distance

Pallor

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Whether black and tarry, magenta or bright red, blood loss here can be significant

Stool

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Among the good dietary sources of iron

Meat

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Forms when Iron occupies its place in protoporphyrin IX

Heme

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Contributes to the reason that 2 of the 4 heme moieties of hemoglobin have a bound O2 molecule at 26.8 torr

Positive Cooperativity

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Adverse consequence of free heme or iron in the body

Oxidative Stress

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While alcohol is the most common cause of sideroblastic anemia, this environmental toxin can also block heme synthesis to cause it

Lead

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Approximately half-saturated with oxygen at 2 torr, reason oxygen can be stripped from hemoglobin and stored in muscles

Myoglobin

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Only actively regulated pharmacokinetic process to control the amount of iron in the body

Absorption

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Peptide produced by the liver that regulates iron homeostasis, increased levels reduce blood levels

Hepcidin

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Heme-containing proteins

Cytochrome P450

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Transports oxygen in the blood

Hemoglobin

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Production is decreased by thalassemic disorders

Globins

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Nanoparticle used to treat iron deficiency, can infuse faster than colloidal iron

Ferumoxytol

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Among the choices for IV administration of iron due to malabsorption or intolerance of oral forms, administration bypasses hepcidin regulation

Iron Dextran

This and sustained-release formulations drastically reduces the bioavailability of orally administered iron

Enteric Coating

Example of Oral Iron Pill

Ferrous Sulfate

Cause nausea and vomiting, diarrhea or constipation, anorexia, heart burn and dark stools

Iron Tablets

can be severe with oral iron administration

GI Irritation

Among the causes of iron loss

Sloughing of Cells

Has been one of the leading causes of death by toxicological agents in children <6yo

Iron Poisoning

Iron Chelator administered as therapy for potentially lethal iron poisoning

Deferoxamin

Period of time required to develop vitamin B12 deficiency, a reflection of daily need vs body stores

Years

Use of this for analgesia during surgery can cause rapid onset of vitamin B12 deficiency symptoms

Nitrous Oxide

Can readily meet their daily needs of vitamin B12 by eating fortified breakfast cereals

Vegetarians

Vitamin B12 deficiency is suggested when this is red/inflamed and smooth

Tongue

Refers to anemia associated with loss of intrinsic factor

Pernicious

Symptoms that, when present with macrocytic anemia, justify parenteral vitamin B12

Neurological

Needed to generate methionine from homocysteine and tetrahydrofolate from 5-methyltetrahydrofolate

Vitamin B12

Infection that can cause pernicious anemia in the absence of autoantibodies

H. pylori

Symmetric form of this +/- alterations in gait and cognition are common neuropsychiatric symptoms of vitamin B12 deficiency

Parasthesia

Glycoprotein secreted by parietal cells, complexes with cobalamin to facilitate its uptake via cubulin receptors in the ileum

Intrinsic Factor

Blocks intrinsic factor-cobalamin interaction or the receptor for it in the ileum, or target H-K-ATPase of parietal cells

Autoantibody

Potential characteristic of neurological pathology due to Vitamin B12 deficiency

Irreversible

Cobalamin

Vitamin B12

Appropriate route of administration for vitamin B12 in pernicious anemia provided dose is 500x daily requirement

Oral

Well known reason for folate intake to be increased

Preganante

Often expected within a few days after initiating appropriate therapy for microcytic or macrocytic anemia; increases in hematocrit and hemoglobin follow shortly thereafter

Reticulocytosis

Plasma levels of this micronutrient fall within 3 weeks of inadequate intake from animal products and leafy vegetables

Folate

Visible GI tract consequences of folate deficiency

Mouth Ulcers

Potentially especially vulnerable to cognitive decline cause by vitamin B12 deficiency that has been masked by the consumption of folate fortified foods

Elderly

Folate deficiency may cause this, but is not associated with the neurological problems caused by vitamin B12 deficiency

Depression

In combination with poor dietary intake, is a common cause of folate deficiency

Alcoholism

Increases in part due to the increased viscosity of blood caused by epoetin alfa

Blood Pressure

Blood doping with recombinant forms of this is banned by the Olympics

Erythropoietin

Cancer chemotherapeutic agent approved for the treatment of sickle-cell anemia because it somehow boosts the levels of fetal hemoglobin, thereby

Hydroxyurea

Increased incidence of this is a predictable consequence of eculizumab therapy, and overwhelming amount can also cause neutropenia

Infection

Prevents formation of complement MAC, treat paroxysmal nocturnal hemoglobinuria caused by insufficient GPI-linked CD59 and CD55 on the RBC cell surface that otherwise protects from this type of attack

Eculizumab

Atypical form of this is an indication for eculizumab

Hemolytic Uremic Syndrome

Recombinant erythropoiesis-stimulating glycoprotein with a.a. sequence identical to erythropoeitin Administered to treat anemia secondary to chronic kidney disease or chemotherapy to reduce the need for allogeneic RBC transfusions

Epoetin Alfa

This use of filgrastim is considered warranted if calculated risk for getting neutropenic fever is >20% or if its use permits timely administration of potentially curative chemotherapy

Prophylaxis

A recombinant granulocyte-colony stimulating factor, it increases growth and proliferation of neutrophil progenitor cells and also facilitates actions of mature neutrophils

Filgrastim

For sargramostim, this includes fluid retention, dyspnea due to sequestration of granulocytes in pulmonary circulation, fatal "grasping syndrome" in premature infants

Adverse Effects

Name means that polyethylene glycol was attached to filgrastim to prolong its half-life

Pegfilgrastim

Considered severe if absolute count of these cells is <500/microliter Low-grade fever, sore mouth, severe pain from swallowing, upper and lower airway inflammation and perianal pain and irritation are among its symptoms

Neutropenia

Recombinant GM-CSF, acts in the bone marrow to increase production of neutrophils, eosinophils, and monocyte/macrophages

Sargramostim

A reason to administer filgrastim +/- plerixafor to mobilize hematopoietic progenitor cells

Leukapheresis

Partial agonist at CXCR4 receptors important for homing of hematopoietic stem cells, an expensive orphan drug administered when G-CSF or GM-CSF alone cannot mobilize enough stem cells for autologous transplant

Plerixafor

Life-threatening complication of chemotherapy

Neutropenic Fever

Adverse effect of filgrastim, sargramostim, and erythropoietin

Bone Pain

Although filgrastim can speed the recovery from severe neutropenia, there is less evidence of impact on this for this expensive drug

Clinical Outcomes

Has potent synergistic actions on early progenitor cells, but cannot be used since this stimulatory effect extends to mast cells and gives rise to severe allergic reactions

Stem Cell Factor

Indication for romiplostim or eltrombopag, after failure of first choice

ITP

A "peptibody" has 2 IgG constant regions linked by a peptide; has no homology to thrombopoietin but nevertheless stimulates the thrombopoietin receptor to promote platelet production

Romiplostim

Orally active non-peptide thrombopoietin agonist approved for treatment of ITP and the thrombocytopenia seen with Hep C

Eltrombopag

Recombinant form of IL-11, early agent that increases platelet levels via unknown mechanism, no longer has a major clinical use

Oprelvekin

Stimulates platelet production in vivo, but recombinant forms for treating thrombocytopenia were withdrawn from the market due to frequent autoantibody production leading to profound thrombocytopenia

Thrombopoietin

Type of anemia frequently caused by cephalosporins and some penicillins

Hemolytic Anemia

Type of anemia caused by cancer chemotherapeutics, chloramphenicol and benzene

Aplastic Anemia

Most common cause of drug induced immune thrombocytopenia

Heparin

Antiarrhythmic drug, a classic cause of drug-induced non-immune thrombocytopenia

Quinidine