Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Mandies Pharm III > Anemias > Flashcards

Anemias Flashcards

1
Q

symptoms of anemia

A

yellowing eyes, pale/cold/yellowing skin, SOB, muscular weakness, change in stool color, fatigue, dizziness, syncope, low BP, palpitations, rapid HR, CP, angina, MI, enlarged spleen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

mature RBC lifespan

A

120 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

time for erythrocyte development

A

5.5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when does loss of nucleus occur in erythrocyte development

A

between orthochronic normoblast and reticulocyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

pure red cell aplasia (erythroblastopenia)

A

reduced proliferation or differentiation of stem cells. occurs w autoimmune disease, thymoma, viral infections, herpes, parvovirus B19, hepatitis, lymphoproliferative, congenital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

aplastic anemia

A
  • reduced proliferation or differentiation of stem cells
  • fanconi anemia (hereditary – autosomal recessive, prob w DNA repair, results in BM failure)
  • anemia of renal failure (insufficient EPO)
  • anemia of endocrine d/o
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

forms of decreased RBC production

A

more common than aplasia or aplastic anemia.

  • megaloblastic anemia
  • thalassemia (deficient globin synthesis)
  • congenital dyserythropoetic anemia (specific assorted deficiencies in genes involved in RBC maturation)
  • anemia of renal failure (dilutional and prob w EPO)
  • anemia of prematurity (diminished EPO)
  • iron deficient anemia (decreased heme)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the best indicator of iron deficiency anemia

A

ferritin (normal 100 (+/- 60), low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

cause of iron deficiency anemia

A

almost always due to insufficient dietary intake
-infants, toddlers, preg woman, anyone w blood loss
US: 12% childbearing age women (higher in AA, mexican)
-most common cause is GI bleed in US; parasite worldwide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

why is iron from meat more readily absorbed

A

attached to heme, more readily absorbed via heme carrier pro 1. non bound must be converted to ferrous iron before it can be taken up through divalent metal transporter 1.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how is iron stored

A

bound to apoferritin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ferroportin

A

transports iron from intestinal cell into blood stream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

transferrin

A

binds ferric ion, transports to BM precursor to transferrin receptor. ferrous converted to hbg. tranferrin receptor and transferrin are recycled. can also deliver iron to hepatocytes to become stored as ferritin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

hepcidin

A

binds to and inhibits ferroportin on all cell types. regulatory hormone that fluctuates with iron status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

features of hemolytic anemias

A
  • increased lactate
  • decreased haptoglobin
  • increased reticulocytes
  • increased bili
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

hemolytic anemias: intrinsic abnormalities

A
  • premature destruction
  • genetic d/o: hereditary spherocytosis, elliptocytosis, enzyme deficiencies, hemoglobinophathies (sickle cell)
  • non genetic: paroxysmal noctural hemoglobinuria; bone marrow cell mutation causes loss of cell surface markers. autoimmune response ensues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

hemolytic anemias: extrinsic abnormalities

A

anti-body related

  • warm autoimmune hemolytic anemia: primarily by IgG. occurs at typical body temp, can be secondary to SLE or CLL
  • cold agglutinin hemolytic anemia: IgM, excessive titer permits binding in cold (28-31), can be secondary to mycoplasma pna, mono, lymphoma, CLL, HIV
  • transfusion rxn
  • Rh disease
  • mechanical trauma (HD, valve, malaria)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

small cell anemia causes

A
  • too little iron
  • too much lead
  • thalasemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

large cell anemia causes

A
  • too little vit B12 or B9

- drug SE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

normal cell size anemia, but bad development

A

-chronic disease, aplastic anemia, enzyme disorders, cell shape, leukemia

21
Q

normal cell size anemia, but bad survival

A
  • hemorrhage

- sickle cells

22
Q

ferrous salts
SE
-Tips

A

-treat mild to mod iron deficiency
SE: dyspepsia, constipation, dark feces
-vitamin C helps absorption
-ferrous sulfate is least expsnsive
-ferrous salts are better than ferric salts
-SR formulationnot recommended, as iron may pass duodenum and jejunum
-pH dependent: no antacids, h2 blockers, PPI
-empty stomach: best effect, worst tolerance
-dose by salt weight not iron content
ferrous gluconate, sulfate, fumarate

23
Q

iron RDA

A

men/post menopause: 8 mg/d women: 18 mg/d

24
Q

what reduces iorn absorption

A

fiber, dairy, phosphastes, tea

25
Q

injectable iron

A
  • rx situations where oral iron does not work (speed, inflammation, GI bleed, chemo, deficit > 1 g)
  • can be delivered simultaneously w EPO
  • should only be used when clearly indicated, as anaphylaxis can occur in up to 3% of patients
26
Q

iron dextran

A

primary choise for parenteral iron; drug allergies and ACE inhibitor use may increase anaphylaxis risk, dilution w dextrose increases pain

27
Q

iron sucrose

A

secondary choise, safe if have dextran rxn. may reduce BP

28
Q

sodium ferric gluconate

A

may drop BP, hypersensitivity rxn, decreased risk vs dextran. used for IDA in HD w EPO

29
Q

ferumoxytol

A

for IDA in CKD. may reduce BP, hypersensitivity. may interfere with MRI for 3 months. serum iron and TSAT may be overestimated

30
Q

overdose of iron rx

A
  • gastric aspiration or vomiting
  • lavage w iron precipitating salts
  • deforoxamine (iron chelator) used for acute iron poisoning or for inherited or acquired hemochromatosis, SC or IM, IV can cause hypotension, LT use can cause neurotoxicity and increased infections
31
Q

acute iron toxicity

A
  • rare in adults
  • can be fatal
  • abd pain and bloody diarrhea in 30 mins
  • hepatic failure w acidosis, coma, death
  • prompt treatment is req to prevent severe necrotizing gastroenteritis
32
Q

chronic iron toxicity

A
  • hemochromatosis/hemosiderosis
  • excess iron depositied in heart, liver, pancreas leading to organ failure and death
  • may occur in pt w hemochromatosis and in pt given excessive amount of iron or mult RBC transfusions
  • rx w intermittent phlebotomy
33
Q

cyanocobalamin

  • indication
  • SE
A

-rx B12 deficiency. do not administer IV d/t anaphylaxis. injection site rxns. hypokalemia, sercondary iron deficiency d/t expansion of reticulocytes

34
Q

hydroxocobalamin

  • indication
  • SE
A

-rx B12 deficiency. do not administer IV d/t anaphylaxis. injection site rxns. hypokalemia, sercondary iron deficiency d/t expansion of reticulocytes; cyanokit antidote for cyanide toxicity. max cumulative dose 10 g

35
Q

folic acid

  • indication
  • SE
A
  • B9 deficiency

- may reduce phenobarb, phenytoin, primidone, raltitrexed. tea can reduce absorption. note: can mask B12 deficiency

36
Q

deoxyadenosylcobalamin

A

needed to convert L-methylmalonyl CoA to succinyl coA for TCA cycle. missing in b12 anemia

37
Q

how does B12 deficiency cause anemia

A

folate cannot be converted to h2 folate, homocysteine cannot be converted to methionine. decreased generation of purines for DNA synth.

38
Q

when is blood transfusion indicated

A

-only v low hgb status (

39
Q

when to use erythropoiesis stimulating agent

A

-only to get patient to lowest acceptable range of Hgb, not for use in CKD unless extreme anemia (

40
Q

epoetin alfa

  • indication
  • SE
  • tips
A
  • CKD, cancer/chemo
  • HTN, thrombotic events, edema, feber, dizziness, insomnia, h/a, pruritis, rash, N/V/D, constipation, dyspepsia, arthralgia, cough, seizure
  • Hgb response 2-6 weeks. d/c after 8-12 weeks.
41
Q

darboepoetin alfa

  • indication
  • SE
  • tips
A

CKD, cancer/chemo

  • edema, HTN, hypotension, fatigue, fever, h/a, dizziness, diarrhea, constipation, N/V, muscle spasms, arthralgia, URI
  • d/c if inadequate after 8 weeks.
42
Q

IL-3

A

-stimulations colony formation of most lines

43
Q

filgastrim

A

G-CSF

  • stimulates neutrophils
  • can moilize hematopoietic stem cells
44
Q

sargramostim

A

GM-CSF

  • stimulates neutrophils
  • can moilize hematopoietic stem cells
45
Q

oprelvekin

A

Il-11

-stimulates megakaryocytic progenitors and PLT

46
Q

romiplostim

A
  • thrombopoietin receptor agonists

- experimental for refractory cases of thrombocytopenia

47
Q

eltrobopag

A
  • thrombopoietin receptor agonists

- experimental for refractory cases of thrombocytopenia

48
Q

hyperbaric oxygen

A
  • allows for increased oxygen content of plasma (hgb independent)
  • for use w exceptional blood loss or situations where transfusions cannot be used due to medical, practical, or religious reasons

Mandies Pharm III (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions