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PEBC > Anemias > Flashcards

Anemias Flashcards

1
Q

According to WHO, an Hb level of <___ g/L in men and <___ g/L in nonpregnant women can be used to diagnose anemia

A

<130 men

<120 women

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2
Q

Blood is made up of 3 components:
1.
2. Buffy coat
3.

A
  1. plasma
  2. hematocrit
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3
Q

What are erythrocytes?

A

Red blood cells

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4
Q

Hemoglobin is part of red blood cell that?

A

Carries oxygen

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5
Q

Anemia results from decreased level of _______ or RBCs

A

Hemoglobin

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6
Q

Clinical presentation of someone with anemia:
1.
2.
3.

A
  1. Weakness
  2. Fatigue
  3. Pale

Short of breath, dizzy, edema, tachycardia

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7
Q

What is hematopoiesis?

A

Maturation of blood components

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8
Q

What is erythropoiesis?

A

Development of red blood cells

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9
Q

____ is the regulatory hormone required for RBC production. Kidney’s produce it in response to reduced oxygen levels

A

EPO, it stimulates the bone marrow

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10
Q

Normal development of RBCs require adequate ____, vitamin ___ and ____

A

folate vitamin b12 iron

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11
Q

An immature red blood cell is called a:

A

Reticulocyte, just before a red blood cell is formed (Erythrocyte)

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12
Q

The ratio (%) of total volume RBC to the total volume of blood is called _________

A

hematocit

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13
Q

Reticulocyte count is the % of ____________ produced and circulating compared to circulating _______

A

Reticulocytes compared to erythrocytes

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14
Q

The amount of iron bound to transferrin is known as

A

Serum Iron

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15
Q

_________ is the main protein in the blood that binds to iron and transports it throughout the body.

A

Transferrin

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16
Q

Transferrin SAT (TSAT) is the ?

A

% iron-binding sites used on transferrin (aka. how much of your stored iron can be used to make new RBC)

A reduced level (<20%) reflects iron deficiency while an elevated level (>50%) indicates iron overload.

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17
Q

TIBC is the amount of iron that could bind to ________

A

transferrin

High TIBC + low serum iron = iron deficiency anemia

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18
Q

_____ and _____ are required in erythropoiesis to generate RBC

A

Vitamin b12 and folate

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19
Q

______ is an iron-storage protein

A

Ferritin (how much iron stored in the body)

20
Q

The 3 types of anemia are:
1.
2.
3.

A
  1. Microcytic
  2. Normocytic
  3. Macrocytic
21
Q

______________ typically presents as a microcytic anemia with a low MCV

A

Iron Deficiency anemia (IDA)

22
Q

A patient with iron deficiency anemia will present with:
1. ______ serum ferritin
2. ______ hemoglobin
3. ______ serum iron
3._______ TIBC
4. Microcytic RBC

A

Low
Low
Low
Increased (high binding capacity, just not enough iron to bind)

23
Q

Microcytic anemia occurs as a result of impaired hemoglobin synthesis. It can be caused by:
1. IDA
2.

A

Thalassemia

24
Q

Common causes of iron deficient anemia:
1.
2.

A
  1. Chronic blood loss
  2. inadequate intake

pregnancy, poor absorption, chronic renal failure

25
Q

Symptoms specific to iron deficiency anemia:
1.
2
3. atrophic glossitis (inflammation of the tongue)
4. inflammation around mouth

A
  1. Koilonychia (concave nails)
  2. PICA (cravings for non-nutritive substances such as clay, ice, cornstarch)
26
Q

Dietary Iron:

Average all males/females:

Menstruating females:

Pregnant females:

A

10

15

30 elemental

27
Q

Iron from plant sources (non-heme) is more or less absorbable?

A

3x less than from animal (heme) sources

28
Q

First line treatment for IDA?
1.

A
  1. Oral Iron supplementation
29
Q

Second line treatment for IDA ?
2.

A
  1. Parenteral iron therapy

reserved for patients who are unresponsive to oral, CKD, malabsorption, need rapid iron, chronic blood loss, gastric resection

careful it can cause anaphylaxis or hypotension

30
Q

Common side effects of oral iron?

A

GI, constipation, dyspepsia

31
Q

These two forms of iron may be better tolerated than iron salts but are less efficacious?
1.
2.

A

Polysaccharide iron complex (FeraMAX)

Heme iron polypeptide (Proferrin) (bovine source)

32
Q

Elemental iron in each product:
Ferrous fumarate:
Ferrous sulfate:
Ferrous gluconate:
FeraMax

A

100
60
35
150

33
Q

Oral iron therapy is best absorbed on ______, absorption can be increased with ______, and calcium antacids tea coffee red wine ______ absorption

A

empty stomach (can take with food if unable to tolerate)

vitamin c

decrease

Treatment may continue for 3-6 months once Hb normalizes, sometimes life long

34
Q

Normocytic anemia is typically due to the following:
1.
2.
3.

A
  1. Anemia of chronic disease
  2. Acute blood loss
  3. Hemolytic anemias (spherocytosis, sickle cell anemia)
35
Q

In normocytic anemia, A ___ reticulocyte count is indicative of anemia of chronic disease

A

LOW

36
Q

In normocytic anemia,
A ____ reticulocyte count is indicative of:
1. Acute blood loss
2. Hemolytic anemias

A

HIGH (body is pumping out lots of reticulocytes instead of RBC)

Acute blood loss
or Hemolytic anemias

37
Q

The following are examples of hemolytic anemias:
1.
2.

A

Spherocytosis (blood disorder, sphere shaped RBC)

Sickle cell anemia (constant RBC shortage due to abnormal C shape RBC which die early)

38
Q

Anemia of chronic disease common presentation:

MCV:
CRP:
Ferritin:
Serum Iron:
TIBC:

A

MCV: normocytic
CRP: HIGH
Ferritin: normal or high
Serum iron: low
TIBC: low

> During inflammation your CRP is elevated, and this causes INC in Hepicidin, it acts to sequester iron from invading bacteria by removing iron from circulation. DEC SERUM iron, INC iron stores.

TIBC is low since already lots stored

39
Q

Medications that interact with iron include:
1.
2.
3.
4. cholestyramine
5. levodopa
6. sodium bicarbonate

A
  1. fq
  2. tetracyclines
  3. PPI
40
Q

Megaloblastic anemias arise because of impaired DNA synthesis of the RBC caused by deficiencies of vitamin ___ or ______

A

B12 or Folate

41
Q

Megaloblastic anemia
lab values:

MCV:
Folate:
B12:

A

INC
Dec
Dec

42
Q

Folate deficiency anemia specific symptoms include:
1.
2.

A

Decreased weight due to loss of appetite

swollen red tongue

43
Q

Duration of folate therapy in folate deficiency anemia is typically up to __ months

A

4 months (sometimes life long) whereas B12 is usually life long

44
Q

Vitamin ___ deficiency must be ruled out before starting folic acid

A

B12 - folic acid supplementation can mask b12 deficiencies which allows the underlying neuropathy to persist

45
Q

Vitamin b12 deficiency anemia is typically due to alcoholics, vegans and elderly. However it may also be caused by this medication:

A

Metformin

46
Q

Vitamin b12 deficiency anemia may present with symptoms like:
1
2

A

1 fatigue
2 headache
palpitations
SOB
ataxia
vision loss

47
Q

Vitamin b12 deficiency anemia must be treated ASAP due to:

A

possible neurological damage

PEBC (35 decks)

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