Anemia- FINAL Flashcards
Definition of Anemia
Condition where blood lacks enough RBCs or hemoglobin to carry oxygen.
Common Causes of Anemia
Nutritional deficiencies, chronic disease, blood loss, hemolysis.
Types of Anemia by Cell Morphology
Microcytic (iron deficiency), Macrocytic (B12/folate deficiency), Normocytic (chronic disease).
Dietary Sources of Iron
Red meat, leafy greens, lentils, fortified cereals.
Dietary Sources of Folic Acid
Leafy greens, citrus fruits, beans, fortified grains.
Dietary Sources of Vitamin B12
Animal products (meat, eggs, dairy), fortified foods.
Advantages Vs. Disadvantages of Ferrous Sulfate
Inexpensive, widely available; GI upset, constipation
Substances That Reduce Iron Absorption
Calcium, tea, coffee, antacids, high-fiber foods.
B12 vs. Folic Acid Deficiency
Both cause macrocytic anemia, but B12 deficiency has neurological symptoms.
Intrinsic Factor (IF)
A stomach protein necessary for B12 absorption; lack leads to pernicious anemia.
Monitoring Iron Deficiency Treatment
Reticulocytes increase in 7-10 days; Hgb improves in 2-4 weeks.
Monitoring B12/Folate Treatment
Neurological improvement in days to weeks; RBCs normalize in 4-8 weeks.
Pharmacology of B12 Supplements
Cyanocobalamin (synthetic) restores B12 levels, usually well tolerated.
Extra: contains a cyanide side group, Studies suggest cyanocobalamin may impair kidney function in people with borderline kidney problems… Safer version (methylcobalamin)
Pharmacology of Folic Acid
Required for DNA synthesis; interacts with methotrexate, phenytoin.
Epoetin Alpha (Erythropoietin) Use
Used in CKD, chemo-induced anemia, requires iron monitoring.
Monitoring Epoetin Alpha Therapy
Target Hgb 10-11 g/dL, avoid >12 g/dL; monitor BP, iron levels.
Red Blood Cell Development
Requires erythropoietin, iron, vitamin B12, and folic acid.
Iron Absorption & Distribution
Absorbed in small intestine, stored in mucosal cells, transported by transferrin.
Iron Deficiency Anemia (IDA) Causes
Dietary deficiency, pregnancy, chronic blood loss.
IDA Symptoms
Pale RBCs, pica, spoon-shaped nails, mouth cracks.
IDA Diagnosis
Low hemoglobin, low iron, low ferritin, increased TIBC.
Oral Iron Preparations
Ferrous sulfate (high iron content (20% elemental), GI upset), ferrous gluconate (12% elemental but better absorption, better tolerated), ferrous fumarate (high content 33% elemental).
Parenteral Iron Therapy
Used when oral iron is ineffective, IV forms include iron dextran (anaphylaxis risk), iron sucrose, ferric gluconate.
Vitamin B12 Importance
Essential for DNA synthesis and neurological function, absorbed via intrinsic factor.
Vitamin B12 Deficiency Causes
Pernicious anemia, gastric surgery, PPI/metformin use, alcoholism.
Vitamin B12 Deficiency Symptoms
Megaloblastic anemia, neurological symptoms (tingling, memory loss).
Folic Acid Importance
Needed for DNA synthesis, prevents neural tube defects in pregnancy.
Folic Acid Deficiency Causes
Poor diet, malabsorption, methotrexate use.
Folic Acid Deficiency Symptoms
Megaloblastic anemia, no neurological symptoms.
Erythropoietin-Stimulating Agents
Epoetin alpha and darbepoetin alpha used for CKD and chemotherapy-induced anemia.
Erythropoietin Therapy Risks
Hypertension, clot risk, stroke, must monitor hemoglobin levels (target 10-11 g/dL); BB warning
Drugs for Sickle Cell Disease
Hydroxyurea (increases fetal hemoglobin), pentoxifylline (reduces blood viscosity).
Benefits of Hydroxyurea
Reduces hospitalizations, pain episodes, and sickle cell crises.
Hematopoietic Agents for Neutropenia
Filgrastim (Neupogen), Pegfilgrastim (Neulasta), Sargramostim (Leukine) stimulate WBC production.
Neutropenia Treatment Risks
Bone pain, rare risk of splenic rupture.
