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Oncology Exam 3 > Chronic Anemia > Flashcards

Chronic Anemia Flashcards

1
Q

Anemia is generally shown when the Hgb levels are

A

<11 g/dL

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2
Q

What patient population experiences anemia more commonly?

A

Women during reproductive years

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3
Q

Anemia is very common in patients with what 2 comorbid conditions?

A
  1. Cancer
  2. Chronic Kidney disease
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4
Q

What is the process stimulated by?

A

Erythropoietin

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5
Q

What do reticulocytes mature into?

A

Erythrocytes

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6
Q

What are 6 symptoms of anemia?

A
  1. Fatigue
  2. Lethargy
  3. SOB
  4. Headache
  5. Edema
  6. Tachycardia
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7
Q

True or False: Anemia is seen as a cause of disease rather than a marker

A

False

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8
Q

What are the 3 main causes of anemia?

A
  1. Decreased RBC production
  2. Increased RBC destruction
  3. Blood loss
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9
Q

What 3 things can cause a decrease in RBC production?

A
  1. Hypoproliferative bone marrow
  2. Decreased production of EPO or decreased response to EPO
  3. Nutritional deficiencies
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10
Q

What 2 things can cause hypoproliferative bone marrow?

A
  1. Cancer
  2. Chemotherapy
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11
Q

What 2 things can cause a decrease in EPO or decreased response to EPO?

A
  1. CKD
  2. Other inflammatory conditions
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12
Q

What are 3 nutritional deficiencies that can cause anemia?

A
  1. Iron
  2. Vitamin b12
  3. Folic acid
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13
Q

What does chemotherapy decrease the production of?

A

Mature erythrocytes

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14
Q

When are blood transfusions the most useful?

A

In severe anemia and life threatening anemia

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15
Q

What Hgb level is considered severe anemia?

A

<8

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16
Q

What Hgb level is considered life threatening anemia?

A

<6.6

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17
Q

Blood transfusions are most useful in cases of ______

A

Active bleeding

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18
Q

What are 2 medications that can increase the production of RBCs?

A
  1. Epoetin Alfa
  2. Darbepoeitin
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19
Q

When are the ESAs used?

A

To prevent and treat anemia associated with cancer and chemotherapy

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20
Q

True or False: both ESA agents are considered equivalent

A

True

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21
Q

What are 4 ADRs of the ESAs?

A
  1. Venous thromboembolism
  2. Hypertension
  3. Cardiovascular events
  4. Stroke
22
Q

ESAs are not indicated in patients who are receiving chemotherapy and the anticipated outcome is _______

A

Cure

23
Q

ESAs should not be used to treat anemia associated with cancer if the patient is not what?

A

Receiving myelosuppressive chemotherapy

24
Q

ESAs are not generally recommended in patients with _________

A

Hematologic malignancies

25
Q

ESA therapy should not begin until the Hgb level is

A

<10 g/dL

26
Q

Hgb should be increased to the ______ concentration needed to avoid what?

A

Lowest; blood transfusion

27
Q

What are all ESAs apart of?

A

REMS program

28
Q

Evaluation of anemia should be initiated in patients with what stage of CKD?

A

Stage 3 or higher

29
Q

What is the target hemoglobin for anemia caused by CKD?

A

10-12 g/dL

30
Q

What brand of ESA is only used for CKD?

A

Epogen

31
Q

Epoetin Alfa

A

PROCRIT

32
Q

Darbepoeitin Alfa

A

ARANESP

33
Q

Adverse effects from ESAs are more common in patients with CKD with what Hgb level?

A

> 13 g/dL

34
Q

What are 2 chronic autoimmune diseases where anemia is common?

A
  1. RA
  2. SLE
35
Q

What is the most common cause of anemia worldwide?

A

Iron deficiency anemia

36
Q

What patients is iron deficiency anemia most common in?

A

Young children and women of childbearing age

37
Q

What is iron stored as?

A

Ferritin

38
Q

What are 3 functions of iron in the body?

A
  1. Oxygen transport
  2. Electron exchange
  3. Control of toxic free radicals
39
Q

What are 4 unique symptoms associated with iron deficiency anemia?

A
  1. Hair loss
  2. Pica
  3. Kolionychia
  4. Inflammation of the angles of the mouth
40
Q

Diet supplementation alone is usually _____

A

Inadequate

41
Q

What is the goal for elemental iron per day?

A

200 mg

42
Q

When is absorption best for iron?

A

One hour before meals

43
Q

What are 4 most common ADRs when taking iron?

A
  1. Constipation
  2. Discoloration of feces
  3. Nausea and vomiting
  4. Heartburn
44
Q

What is the goal for iron replacement?

A

1000 mg per treatment course

45
Q

What 5 ADRs can be caused by IV iron replacement?

A
  1. Anaphylaxis
  2. Infusion related reactions
  3. Cramps
  4. Diarrhea
  5. Hypotension
46
Q

What 4 things can cause vitamin b12 deficiency?

A
  1. Poor intake
  2. Malabsorption
  3. Inadequate utilization
  4. Medications
47
Q

How would you treat a vitamin b12 deficiency?

A
  1. Treat underlying problem
  2. Replacement
48
Q

What 3 things can cause a folate deficiency?

A
  1. Inadequate intake
  2. Malabsorption
  3. Increased requirement
49
Q

How do you treat folic acid?

A

Replacement

50
Q

What can an increase in destruction of RBCs be caused by?

A

Steroids

Oncology Exam 3 (6 decks)

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