Anemia - Rogers

Question 1

what are symptoms of anemia

Answer 1

exertional dyspnea, angina, tachycardia, fatigue, pallor

Question 2

what is a normal Hgb value for males?***

Answer 2

> 13.5 g/dL

Question 3

What is a normal Hgb value for females?***

Answer 3

> 12 g/dL

Question 4

What is a normal MCV?

Answer 4

80-100 mm3

Question 5

what are the microcytic anemias?

Answer 5

iron deficiency, sickle cell, thalassemia

Question 6

what are the normocytic anemias?

Answer 6

chronic disease, blood loss, hemolysis

Question 7

what are the macrocytic anemias?

Answer 7

folic acid and/or B12 deficiency

Question 8

what are the characteristics of iron deficient anemia?

Answer 8

decreased Hgb
decreased MCV
decreased ferritin and serum iron
decreased TSAT

Question 9

what is the normal value range for ferritin?

Answer 9

15-200 mg/dL (decreased in iron deficiency)

Question 10

what is the normal range for TSAT

Answer 10

20-50% (decreased in iron deficiency)

Question 11

treatment of iron deficient anemia

Answer 11

oral iron preferred
exceptions: cannot tolerate, cannot absorb, ESRD, heart failure (then IV iron)
address underlying cause

Question 12

doing for oral iron

Answer 12

65mg elemental QOD
OR
120-200mg elemental daily (BID or TID)

Question 13

concentrations of oral iron

Answer 13

ferrous gluconate (10%), ferosul (20%), fumarate (33%)

Question 14

characteristics of B12 anemia

Answer 14

decreased Hgb
increased MCV
decreased serum B12

Question 15

B12 deficiency treatment

Answer 15

IM or SQ
100-1000 daily, weekly, or monthly
Oral
1000-2000 mcg/day
water soluble vitamin

Question 16

drugs that cause B12 deficiency

Answer 16

PPIs, Metformin

Question 17

characteristics of folic acid deficiency

Answer 17

decreased Hgb
increased MCV
decreased serum folate (<10 ng/mL)

Question 18

medications that can cause folic acid deficiency

Answer 18

methotrexate, phenytoin, sulfasalazine, bactrim

Question 19

treatment for folic acid deficient anemia

Answer 19

1-5mg daily until Hgb normalizes (most commonly 1mg)
- always check vitamin B12 too!

Question 20

how to treat anemia of CKD

Answer 20

• avoid blood transfusions
• supplement folate and B12
• oral or IV iron
• Target TSAT >30%
• Use ESAs minimum dose to target Hgb>10
• only start ESAs after replenishing iron

Question 21

Heart failure and anemia treatment

Answer 21

treat with iron infusions (IV)
- decreased HF hospitalizations
- did not improve overall survival
- No benefit from oral iron
- do not use ESAs

Question 22

treatment for blood loss anemia

Answer 22

transfuse with packed red blood cells when Hgb <7

Question 23

How much elemental iron does a unit of packed red blood cells contain?

Answer 23

250mg

Question 24

treatment for sickle cell anemia

Answer 24

• 1mg/day folic acid
• blood transfusions
• hydroxyurea (10-15mg mg/kg/day\
• immunizations and pain control