Anemia powerpoint

Question 1

When patient has anemia what does a person feel like?lightheaded,__________,________

Answer 1

tired, worn out

Question 2

Anemia is defined by the World Health Organization (WHO)
as a hemoglobin (Hb) concentration
<_______g/dL for adult males and postmenopausal women

Answer 2

<13.0 g/dL

Question 3

Anemia is defined by the World Health Organization (WHO)
as a hemoglobin (Hb) concentration

<______g/dL for premenopausal women

Answer 3

<12.0 g/dL

Question 4

Even with treatment, many patients with Anemia in CKD will fall into the “anemic” range

Question 5

With anemia prevalence increases as eGFR __________ (as pt’s kidney function declines they are at risk for worse outcomes)

Answer 5

declines

Question 6

If prevalence is going to increase as your GFR declines what do you think that means as far as things like screening? More frequent screening is needed as pt’s GFR declines

Question 7

Clinical Presentation of Anemia
Patients may be asymptomatic

Fatigue, SOB (shortness of breath), chest pain, tachycardia, tingling in the extremities, general malaise, headaches, cold intolerance

Question 8

All patients are screened for anemia when they are first evaluated for CKD with a ________________ (CBC)

Answer 8

complete blood count

Question 9

If found to have low hemoglobin, should have further evaluation
CBC, Red blood cell (RBC), reticulocyte count, serum iron, total iron-binding
capacity (TIBC), percent transferrin saturation (TSAT), serum ferritin, serum folate
vitamin B12 levels, test for occult blood in stool (Tsat) = (serum iron/TIBC) x 100%

Why do we do so many labs? to see if something is causing anemia maybe pt has a GI bleed and thats why they have low hemoglobin levels

Question 10

Why are we looking at vitamin B12 or folate?

Answer 10

someone might have a deficiency and we need to replete these things before giving them therapies

Question 11

If no underlying cause found, continue to screen all patients with CKD

Question 12

Frequency of testing for anemia

For CKD pts w/o anemia measure Hb concentration when clinically indicated and at least __________in pts with CKD3

at least _____per year in pts with CKD 4-5ND (ND is not on dialysis)

at least 3 every 3 months in pts w/CKD 5HD and CKD 5PD (HD is hemodialysis and PD is peritoneal dialysis)

Answer 12

annually

twice per year

Question 13

Pts with CKD 3 (so 3a and 3b) is GFR at what range?

Answer 13

30-59

Question 14

Screening for anemia we look at ________deficiency

Answer 14

iron deficiency

Question 15

___________:primary cause of resistance to treatment of anemia with standard therapy. If pts don’t have adequate iron stores they could be potentially resistant to ESAs

Answer 15

iron deficiency

Question 16

ESAs (erthropoeitn stimulating agents) are retacrit and procrit

Question 17

Why do we screen for HIV and malignancies? pts with these disease states have ____immune systems

Answer 17

weakened

Question 18

Diagnosis of anemia
Diagnose anemia in adults and children >15 years with CKD when the Hb concentration is less than 13.0g/dl in males and less than 12 in females