Anemias

Question 1

Anemia Defined

Answer 1

Reduction of RBC’s or hemoglobin in the blood

Question 2

Acute Posthemorrhagic Anemia / acute blood loss: Therapy

Answer 2

Hemostasis, restore blood volume, treat shock

Question 3

Sickle Cell Anemia: Definition

Answer 3

Autosomal recessive d/o in which abnormal hgb leads to chronic hemolytic anemia

Presence of hemoglobin S in RBCs

When erythrocyte is stressed, the erythrocyte loses its oxygen causing the cell integrity to be lost and to sickle damaging the endothelium of the circulation

Question 4

Sickle Cell Anemia Treatment Goals

Answer 4

Prevent and treat complications
Immunizations up to date
Folic acid supplementation 2/2 erythropoiesis

Question 5

Hydroxyurea for Sickle Cell Anemia: MOA

Answer 5

Increases Hgb F levels, water content of RBCs, deformability of sickle cells, and alters the adhesion of RBCs to the endothelium

Question 6

Iron Deficiency Anemia: Cause

Answer 6

r/t insufficiency iron intake, inadequate iron absorption, or increased iron demands

Iron is involved in the production of cytochromes and other enzymes.
Immediately bioavailable
Bound in the bloodstream to a specific carrier protein, transferrin

Question 7

Iron Deficiency Anemia: Iron Replacement Therapy

Answer 7

Supplemental iron without food, adding vitamin C improves absorption

IV Iron Dextran
SE’s: nausea, vomiting, pruritus, HA, flushing, myalgia, arthralgia, back and chest pain

Question 8

Iron Deficiency Anemia: Iron Replacement Therapy: SE’s

Answer 8

GI difficulties - discolored feces, anorexia, constipation, diarrhea, N/V

Question 9

Iron Deficiency Anemia: Iron Replacement Therapy: Interactions

Answer 9

Many ABX cause decreased iron absorption
Decreased absorption when given with aluminum, calcium, or magnesium
PPI’s have decreased iron absorption

Question 10

Anemia of chronic renal failure: Definition

Answer 10

Due to reduced EPO production by the kidney occurring when the GFR declines below 60mL/min

Question 11

Anemia of chronic renal failure: Epoetin and Darbepoetin MOA

Answer 11

Recombinant hormones that stimulate the production of RBCs from the erythroid tissues of the bone marrow

Question 12

Anemia of chronic renal failure: Epoetin and Darbepoetin Contraindications

Answer 12

In Pts with uncontrolled HTN
Hypersensitivity to human albumin

Question 13

Anemia of chronic renal failure: Epoetin and Darbepoetin SE’s

Answer 13

HTN, HA, Sz, arthralgia, Nausea, edema, fatigue, diarrhea, vomiting, chest pain, asthenia, dizziness

Question 14

Thalassemia Definition

Answer 14

Hereditary d/o of Hgb synthesis
India and China descent
Beta-Thalassemia: Mediterranean origin
Hemoglobinopathy is associated with decreased production of alpha or beta globins

Question 15

Thalassemia Treatment

Answer 15

Folate
Avoid iron and oxidative drugs (sulfonamides)
Regular transfusion schedule for severe thalassemias
Iron chelation therapy

Question 16

Vitamin B12 Deficiency: Pernicious Anemia Definition

Answer 16

Impaired deoxyribonucleic acid synthesis. Absence of intrinsic factor inhibiting absorption of vitamin B12
High risk; older adults, alcoholics, malnutrition, strict vegans, weight loss surgery

Question 17

Vitamin B12 Deficiency: Pernicious Anemia Treatment

Answer 17

Vitamin B12 / Cyanocobalamin

Parenteral Cyanocobalamin every day x 1 week followed by once per week for 4 weeks

Question 18

Folate Deficiency Anemia: Definition and cause

Answer 18

Lack of folate leads to large, functionally immature erythrocytes (megaloblasts)
Inadequate intake, inadequate absorption, inadequate utilization, increased requirement, increased excretions

Question 19

Folate Deficiency Anemia: Symptoms

Answer 19

Weakness
Fatigue
Difficulty concentrating
Irritability
HA
SOB
Palpitations

Question 20

Folate Deficiency Anemia: Treatment

Answer 20

Folate replacement
Diet rich in fruits and vegetables

Question 21

Aplastic Anemia: Definition

Answer 21

Condition of bone marrow failure that can be hereditary or arise from injury to or abnormal expression of the stem cell
Pancytopenia with a hypocellular bone marrow