Ch 55 Deficiency Anemias Flashcards
The principal cause of iron deficiency is increased iron
demand secondary to (3).
(1) maternal and fetal blood volume expansion during pregnancy;
(2) blood volume expansion during infancy and early childhood; or
(3) chronic blood loss, usually of GI or uterine origin.
The major consequence of iron deficiency is __.
microcytic, hypochromic anemia.
__ is the drug of choice for iron deficiency.
Ferrous sulfate (given PO)
Iron-deficient patients who cannot tolerate or absorb oral
ferrous salts are treated with __.
parenteral iron—usually iron dextran administered IV.
The major adverse effects of ferrous sulfate are __.
GI disturbances.
These are best managed by reducing the dosage (rather than by administering the drug with food, which would greatly reduce absorption).
Parenteral iron dextran carries a significant risk of ___.
fatal anaphylactic reactions.
The risk is much lower with other parenteral iron products (e.g., iron sucrose).
When iron dextran is used, a small test dose is required
before each full dose. Be aware, however, that patients
can experience ___.
anaphylaxis and other hypersensitivity reactions from the test dose, and patients who did not react to the test dose may still have these reactions with the full dose
The principal cause of vitamin B12 deficiency is __.
impaired absorption secondary to lack of intrinsic factor
The principal consequences of B12 deficiency are (2).
megaloblastic (macrocytic) anemia and neurologic injury.
Vitamin B12 deficiency caused by malabsorption is treated ___.
lifelong with cyanocobalamin
Traditional treatment consists of IM injections administered monthly. However, large oral doses administered daily are also effective, as are intranasal doses (administered weekly with Nascobal).
For initial therapy of severe vitamin B12 deficiency, __.
parenteral folic acid is given along with cyanocobalamin.
When folic acid is combined with vitamin B12 to treat B12
deficiency, it is essential that the dosage of B12 be adequate because folic acid can mask __.
continued B12 deficiency (by improving the hematologic picture), while allowing the neurologic consequences of B12 deficiency to progress.
The principal causes of folic acid deficiency are (2).
poor diet (usually in patients with alcohol use disorder) and malabsorption secondary to intestinal disease.
The principal consequences of folic acid deficiency are
(2) in the developing fetus.
megaloblastic anemia and neural tube defects
To prevent neural tube defects, all women who may become pregnant should ingest __.
400 to 800 mcg of supplemental folate daily, in addition to the folate they get in food.
