Antianemia Drugs Flashcards
f this woman has macrocytic anemia, an increased serum concentration of transferrin, and a normalserum concentration of vitamin B12, the most likely cause of her anemia is deficiency of which of thefollowing?
(A) Cobalamin(B) Erythropoietin(C) Folic acid(D) Intrinsic factor(E) Iron
Deficiencies of folic acid or vitamin B12 are the most common causes of megaloblastic anemia. If a patient with this type of anemia has a normal serum vitamin B12 concentration, folate deficiency is the mostlikely cause of the anemia. The answer is C.
The laboratory data for your pregnant patient indicate that she does not have macrocytic anemia butrather microcytic anemia. Optimal treatment of normocytic or mild microcytic anemia associated withpregnancy uses which of the following?
(A) A high-fiber diet(B) Erythropoietin injections(C) Ferrous sulfate tablets(D) Folic acid supplements(E) Hydroxocobalamin injections
Iron deficiency microcytic anemia is the anemia that is most commonly associated with pregnancy. In this condition, oral iron supplementation is indicated. The answer is C.
If this patient has a young child at home and is taking iron-containing prenatal supplements, she should be warned that they are a common source of accidental poisoning in young children and advised to make a special effort to keep these pills out of her child’s reach. Toxicity associated with acute iron poisoning usually includes which of the following?
(A) Dizziness, hypertension, and cerebral hemorrhage(B) Hyperthermia, delirium, and coma(C) Hypotension, cardiac arrhythmias, and seizures(D) Necrotizing gastroenteritis, shock, and metabolic acidosis(E) Severe hepatic injury, encephalitis, and coma
Acute iron poisoning oen causes severe gastrointestinal damage resulting from direct corrosive effects,shock from fluid loss in the gastrointestinal tract, and metabolic acidosis from cellular dysfunction. The answer is D.
The child in the previous question did ingest the iron-containing supplements. What immediatetreatment is necessary? Correction of acid-base and electrolyte abnormalities and
(A) Activated charcoal(B) Oral deferasirox(C) Parenteral deferoxamine(D) Parenteral dantrolene
Activated charcoal does not bind iron and thus is ineective. Oral deferasirox is eective for chronic irontoxicity. Dantrolene inhibits Ca2+ release from the sarcoplasmic reticulum and is an antidote formalignant hyperthermia induced by inhaled anesthetics. The answer is C.
A 45-year-old male stomach cancer patient underwent tumor removal surgery. Aer surgery, hedeveloped megaloblastic anemia. His anemia is caused by a deficiency of X and can be treated with Y.
(A) X = intrinsic factor; Y = folic acid.(B) X = intrinsic factor; Y = vitamin B12(C) X = extrinsic factor; Y = parenteral iron(D) X = extrinsic factor; Y = sargramostim
Resection of the stomach does lead to loss of intrinsic factor and the patient will be deficient in vitaminB12. Prevention or treatment of iron deficiency anemia (microcytic cell size) is the only indication for ironadministration. Sargramostim is a GM-CSF and is used to stimulate the production of neutrophils andother myeloid and megakaryocyte progenitors. The answer is B.
Which of the following is most likely to be required by a 5-year-old boy with chronic renal insuiciency?
(A) Cyanocobalamin(B) Deferoxamine(C) Erythropoietin(D) Filgrastim (G-CSF)(E)Oprelvekin (IL-11)
The kidney produces erythropoietin; patients with chronic renal insuiciency oen require exogenouserythropoietin to avoid chronic anemia. The answer is C.
In a patient who requires filgrastim (G-CSF) aer being treated with anticancer drugs, the therapeuticobjective is to prevent which of the following?
(A) Allergic reactions(B) Cancer recurrence(C) Excessive bleeding(D) Hypoxia(E) Systemic infection
Filgrastim (G-CSF) stimulates the production and function of neutrophils, important cellular mediators ofthe innate immune system that serve as the first line of defense against infection. The answer is E.
The megaloblastic anemia that results from vitamin B12 deficiency is due to inadequate supplies of which of the following?
(A) Cobalamin(B) dTMP(C) Folic acid(D) Homocysteine(E)N5-methyltetrahydrofolate
Deficiency of vitamin B12 (cobalamin) leads to a deficiency in tetrahydrofolate and subsequently adeficiency of the dTMP required for DNA synthesis. Homocysteine and N5-methyltetrahydrofolateaccumulate. The answer is B.
After undergoing surgery for breast cancer, a 53-year-old woman is scheduled to receive 4 cycles of cancer chemotherapy. The cycles are to be administered every 3–5 wk. Her first cycle was complicated by severe chemotherapy-induced thrombocytopenia. During the second cycle of chemotherapy, it would be appropriate to consider treating this patient with which of the following?
(A) Darbepoetin alpha(B) Filgrastim (G-CSF)(C) Iron dextran(D)Oprelvekin (IL-11)(E) Vitamin B12
Oprelvekin (IL-11) stimulates platelet production and decreases the number of platelet transfusionsrequired by patients undergoing bone marrow suppression therapy for cancer. The answer is D.
After undergoing surgery for breast cancer, a 53-year-old woman is scheduled to receive 4 cycles of cancer chemotherapy. The cycles are to be administered every 3–5 wk. Her first cycle was complicated by severe chemotherapy-induced thrombocytopenia.
Twenty months after finishing her chemotherapy, the woman had a relapse of breast cancer. The cancer was now unresponsive to standard doses of chemotherapy. The decision was made to treat the patient with high-dose chemotherapy followed by autologous stem cell transplantation. Which of the following drugs is most likely to be used to mobilize the peripheral blood stem cells needed for the patient’sautologous stem cell transplantation?
(A) Erythropoietin(B) Filgrastim (G-CSF)(C) Folic acid(D) Intrinsic factor(E)Oprelvekin (interleukin-11)
The success of transplantation with peripheral blood stem cells depends on infusion of adequatenumbers of hematopoietic stem cells. Administration of G-CSF to the donor (in the case of autologoustransplantation, the patient who also will be the recipient of the transplantation) greatly increases thenumber of hematopoietic stem cells harvested from the donor’s blood. The answer is B.
